scholarly journals Bell's palsy: а literature reference and own clinical case

2021 ◽  
pp. 83-87
Author(s):  
D.S. Khapchenkova ◽  
◽  
S.О. Dubyna ◽  
K.Yu. Yena ◽  
◽  
...  
Keyword(s):  
Facial Nerve ◽  
Facial Expressions ◽  
Muscle Weakness ◽  
Clinical Case ◽  
Bell’S Palsy ◽  
Motor Nucleus ◽  
Bell's Palsy ◽  
Facial Muscles ◽  
The Face ◽  
The Right

Bell's palsy is an acute peripheral paralysis of the facial nerve of unknown etiology. The facial nerve is the seventh cranial nerve. One part of the facial nerve is the motor fibers that innervate the facial muscles. The facial nerve emerges from the brain between the posterior edge of the pons and the medulla oblongata with two roots. The main motor nucleus is responsible for the voluntary control of facial muscles. There are central and peripheral paresis of the facial nerve. Central paresis occurs during а stroke. Peripheral paresis (unilateral muscle weakness of the entire half of the face) develops when the facial nerve is affected from the motor nucleus to the exit from the stylomastoid foramen. Among the various localizations of damage to the peripheral part of the facial nerve, the most common is Bell's palsy as a result of edema and compression of the nerve in the bone canal. Clinical symptoms of facial nerve neuropathy are characterized by acute paralysis or paresis of facial muscles: smoothed skin fold on the affected side of the face; swelling of the cheeks; an inability to close the eyelid, Bell's symptom; facial muscle weakness. The degree of damage is determined by the House Brackmann scale. Treatment with glucocorticosteroids, antiviral drugs, physiotherapy procedures. Purpose — to present a clinical case of a patient with Bell's palsy as an example of delayed diagnosis, treatment and, as a result, long-term restoration of the facial muscles functions. Clinical case. The boy after suffering from the flu, began to complain of acute ear pain, vomiting, lack of movement in the right half of the face, dizziness, insomnia. Asymmetry of the face, lack of movement of the right side of the face, inability to completely close the right eye, a symptom of sailing on the right, muscle weakness were revealed during examination. The general condition of the patient improved, facial expressions were restored, sleep was normalized after hormonal, metabolic therapy, physiotherapy procedures. Conclusions. The article describes a case of inflammation of the facial nerve or Bell's palsy in a teenager who developed on the background of the flu. Timely diagnosis and treatment of the above pathology is the key to a satisfactory prognosis for the restoration of facial expressions, prevention of negative consequences of the the disease. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: facial nerve, Bell's palsy, flu, inflammation.

scholarly journals Clinical Case of Facial Muscles Function Recovery in a Patient With Idiopathic Lesions of the Facial Nerve With Unfavorable Myographic Predictors

2021 ◽  
Vol 10 (1) ◽  
pp. 216-223
Author(s):  
K. I. Chekhonatskaya ◽  
L. B. Zavaliy ◽  
M. V. Sinkin ◽  
L. L. Semenov ◽  
G. R. Ramazanov ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Clinical Case ◽  
Complete Recovery ◽  
Correct Choice ◽  
Clinical Situation ◽  
Bell’S Palsy ◽  
Negative Consequences ◽  
Bell's Palsy ◽  
Facial Muscles ◽  
Choice Of Treatment

The facial nerve (fn) palsy is a disease of the peripheral nervous system that leads to aesthetic, organic and functional disorders. The causes of the disease are different, the most common is the idiopathic form bell’s palsy. With a conservative approach to therapy, up to 80% of patients note the complete recovery of the lost functions of facial muscles, the others have the likelihood of severe consequences. Electroneuromyography is used to assess the risk of a negative outcome of the disease. In cases of confirmation of severe nerve damage, surgical treatment is suggested. The article presents a clinical case of complete recovery of the function of facial muscles in a patient with severe damage to the a nerve and an unfavorable prognosis. The course of the disease, complications of bell’s palsy and methods of their correction are described. Timely correct choice of treatment tactics and prevention of complications minimizes negative consequences. When working with a patient, a differentiated approach is important depending on the clinical situation.

scholarly journals The Epidemiology and Management of Bell’s Palsy in the Sudan

2018 ◽  
Vol 12 (1) ◽  
pp. 827-836 ◽  
Author(s):  
Ahmed Hassan Kamil Mustafa ◽  
Ahmed Mohammed Sulaiman
Keyword(s):  
Facial Nerve ◽  
Bell’S Palsy ◽  
Facial Nerve Paralysis ◽  
Age Group ◽  
Bell's Palsy ◽  
Cross Sectional ◽  
Nerve Paralysis ◽  
Dental Hospital ◽  
The Face ◽  
The Right

Background: Bell’s palsy is an acute idiopathic facial nerve paralysis of sudden onset. It is the most common cause of lower motor neuron facial nerve paralysis with an annual incidence of 15-30 per 100,000. The objective of this work is to study the prevalence and the management of Bell’s palsy in the Sudan. A descreptive retrospective cross-sectional study was carried at Khartoum Teaching Dental Hospital, Khartoum General Teaching Hospital. In the retrospective, the records and files of 698 patients with Bell’s palsy, were reviewed in relation to age, gender, site, risk factors, season, and type of treatment. In addition, 48 patients with Bell’s palsy were evaluated using the House–Brackman scale in relation to the above-mentioned variables. Therefore, a total number of 746 cases were studied. Fifty five percent of them were females and the remaining 45% were males, around 38% of them were in the age group 21-40 year. Fifty seven percent of the patients were affected on the right side of the face. Winter was the commonest season of onset where 53.5% of the cases occurred. Steroids are the commonly prescribed drugs in majority of the cases, accounting for 47.3%. Study Design: The study is a retrospective cross sectional hospital based study. The study was carried out in Khartoum Teaching Dental Hospital and in the Physiotherapy Department of Khartoum Teaching General hospital. The files and records of the patients with Bell’s palsy in Khartoum Teaching Dental Hospital in the years 1/1/2004 -31/12/2008, and Khartoum Teaching General Hospital (physiotherapy department) in the years 2007- July 2009 (total number 746). Results: A total number of 746 cases were studied . Fifty five percent of them were females and the remaining 45% were male. Around 38% of them were in the group 21-40 year. Fifty seven percent of the patients were affected on the right side of the face. Winter was the commonest season of the onset where 53.5% of the cases occurred. Conclusion: The study showed predominance of females. A peak incidence was seen in the age group 21-40 years. A predilection was found for the right side of face.

scholarly journals Nerve conduction study in rehabilitation of patients with residuals and complications of long-standing Bell's palsy

2018 ◽  
Vol 27 (3) ◽  
pp. 39-45
Author(s):  
A. Pashov
Keyword(s):  
Facial Nerve ◽  
Facial Expressions ◽  
Reference Electrode ◽  
Bell’S Palsy ◽  
Grading System ◽  
Standard Protocol ◽  
Bell's Palsy ◽  
Facial Muscles ◽  
Detailed Assessment ◽  
Time Required

From every 100 cases of Bell’s palsy (idiopathic peripheral facial palsy) from 15 to 30 will not recover completely. Some residuals will remain, and some complications will develop. As residuals, one can name weakness of facial muscles, asymmetry of facial expressions, distortion of taste, hyperacusis, dry eye. Possible complications of long-standing Bell’s palsy (BP) are also numerous: contractures of facial muscles, pathological synkinesis, mass movements, crocodile tears, facial pains, headaches, emotional disbalance etc. Unresolved cases of Bell’s palsy require rehabilitation programs that will address both the issues of general nerve regeneration, complications and irregularities in mimetic movements, and psycho-emotional state of long-standing Bell’s palsy patients. There are several methods and systems to assess the condition of facial nerve and functioning of facial muscles. These scales and systems are either therapist- or patient-graded: House-Brackmann Facial Grading system, Sunnybrook Facial Grading system, Facial Clinimetric Evaluation Scale (FaCE Scale), Synkinesis Assessment Questionnaire (SAQ) and several others. At the same time, to compose a well-balanced and focused rehabilitation program, next to subjective assessments and test-photos of standard facial expressions, it is important to have an objective, instrumentally-measured picture of facial nerve recovery, as well as of the physiological ability of mimetic muscles to perform facial movements, to reflect emotions and to produce articulated speech. In that respect, the surface EMG or Nerve Conduction Study (NCS) is the modality of choice. NCS-examination is non-invasive and is relatively easy to perform. It records Compound Muscle Action Potentials (CMAPs) in response to external stimulation. The analysis of recorded graphs allows to evaluate the level of regeneration and maturity of recovering axons in main branches of the facial nerve. At the same time, the standard protocol of NCS does not offer a detailed assessment of each particular muscle of facial expression. It also requires additional time to swap the active electrode position when changing stimulation side from right to left and vice versa. At Crystal Touch Bell’s palsy clinic, we have developed an amended NCS protocol that addresses all mentioned issues. To allow a more detailed assessment of facial muscles, we have added mm.zygomatici (major et minor) and m.depressor anguli oris to the list of measured facial muscles. In order to perform a more focused stimulation and to receive a more “clean” motor responses from facial muscles, we changed the position of stimulating electrode. In the standard protocol, stimulating electrode is placed either pre- or post-auricularly. In Crystal Touch protocol, we position the stimulating electrode above each particular nerve branch that innervates the measured muscle. Therefore, we use six positions of stimulating electrode that correspond to the six measured facial muscles: m.frontalis, m.orbicularis oculi pars superioris, m.nasalis et m.levator labii superioris, mm.zygomatici (major et minor), m.orbicularis oculi pars superioris, m.depressor anguli oris et m.mentalis. To save time required for the examination, instead of placing reference electrode on the nasal bridge (standard protocol), we use contralateral electrode over the same as measured muscle, as a reference electrode. As there are no anastomoses between left and right facial nerves, stimulation of facial nerve on one side will not evoke CMAPs in contralateral facial muscles. This simple amendment allows to save about 15% of total time required for the examination. In this article we also briefly touch the following issues: distortion in reciprocal inhibition of facial muscles-antagonists, forming of the pathological mimetic patterns in the motor cortex due to lack of proprioceptive feedback during long recovery, and the necessity to further investigate from the electrotechnical, engineering and functional point of view the hypothesis of aberrant regeneration as possible cause of facial synkinesis.

scholarly journals COMPLETE MANAGEMENT OF ARDITA (BELL’S PALSY) AS PER AYURVEDA CHIKITSA SUTRA – A CASE REPORT

2021 ◽  
Vol 09 (3) ◽  
pp. 650-656
Author(s):  
Ram Lakhan Meena ◽  
Santoshkumar Bhatted ◽  
Nilam Meena
Keyword(s):  
Case Report ◽  
Adverse Effects ◽  
Facial Nerve ◽  
Present Report ◽  
Complete Recovery ◽  
Bell’S Palsy ◽  
Bell's Palsy ◽  
Contemporary Science ◽  
The Face ◽  
Grading Scale

Bell’s palsy, also known as acute idiopathic lower motor neuron facial paralysis, is characterized by sud-den onset paralysis or weakness of the muscles to one side of the face controlled by the facial nerve. In contemporary science, administration of steroids is the treatment of choice for complete facial palsy. Cer-tain Panchakarma procedures and internal Ayurvedic medicines have been proved to be beneficial in the management of Ardita vata. The present report deals with a case of 62-year-old male patient diagnosed as Ardita vata was treated with various Panchakarma procedures like Nasya, Shirobasti, Kukkutanda Swedana, Dashmoola Ksheer Dhoom, Gandoosh and oral Ayurveda medicines. Criteria of assessment was based on the scoring of House-Brackmann Facial Nerve Grading scale. After completion of Ayurveda treatment, the patient Shown almost complete recovery without any adverse effects. This case is an evi-dence to demonstrate the effectiveness of Ayurveda treatment in case of Ardita vata (Bell’s palsy).

scholarly journals Clinical Study of Bell's Palsy at Tertiary Care: Our Experience

2019 ◽  
Vol 02 (01) ◽  
pp. 16-20
Author(s):  
M. B. Bharathi ◽  
Thanzeem Unisa ◽  
Swathi Chandresh ◽  
Venkatesh C. R. ◽  
Harsha S.
Keyword(s):  
Facial Nerve ◽  
Tertiary Care ◽  
Bell’S Palsy ◽  
Cross Sectional Study ◽  
Bell's Palsy ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Number Of Patients ◽  
The Face ◽  
History Of

Abstract Introduction Bell's palsy (BP) is the common cause of facial palsy. This study aims to report and analyze the age, sex distribution, symptomatology, site of lesion, and prognosis in 101 patients with (BP). Materials and Methods This is a cross-sectional study conducted at tertiary referral center, JSS Hospital, Mysuru. All patients consenting to participate in this study, of all ages, of either sex, both outpatients and inpatients with a diagnosis of BP during this study period were included. Results Of the 101 patients analyzed, maximum cases (25.7%) were in third decade of age; 55.4% were males, and both right and left sides of the face were equally involved. Maximum number of patients (50.5%) had a history of postaural pain at presentation Topodiagnostic tests showed majority of BP cases involving geniculate or suprageniculate regions (67.3%) in our study. 20.8% had lesion above the nerve to stapedius, and 11.9% had lesion below the nerve to stapedius. Electrodiagnostic test—electroneuromyography (ENMG)—was abnormal in 57 (67.1%) individuals at day 4. 50.4% of patients had a House-Brackmann (HB) facial nerve grade IV at presentation. 90% of the BP group in our study recovered normal to near-normal facial nerve function by the end of 28 days’ time. Conclusion Each case of BP should be evaluated with thorough clinical examination, topodiagnostic tests, and electrodiagnostic tests. Appropriate management will help in almost full recovery of disease.

scholarly journals A REVIEW STUDY ON THE MODE OF ACTION OF KSHEERA DHOMA IN THE MANAGEMENT OF ARDITA (BELL’S PALSY)

2021 ◽  
Vol 09 (1) ◽  
pp. 179-182
Author(s):  
Supriya Guddad ◽  
Shanakarling Maidaragi
Keyword(s):  
Facial Nerve ◽  
Medical Condition ◽  
Motor Impairment ◽  
Facial Asymmetry ◽  
Bell’S Palsy ◽  
Modern Medicine ◽  
Bell's Palsy ◽  
Tactile Sensibility ◽  
The Face ◽  
Review Study

Arditais a medical condition causing the Vakratha[deviation] of Mukha ardha and leads to facial asymmetry and malfunction. It occurs due to aggravated Vatadosha. It has been included in Vataja Nanatmaja Vyadhi. It can be correlated to facial palsy in modern which carries similar complaints to Ardita of deviation of half of the face with sensory & motor impairment on the affected side. Acharya Sushruta and Charaka mentioned Nadi sweda in the Ardita chikitsa sootra. The modified form of Nadisweda itself is Ksheera Dhooma. As there is a weakness of Facial nerve in Bell’s palsy and the same moist heat is indicated in Bell's palsy by modern medicine. This effect is ensured by Swedana and it has the capacity to stimulate the nerve centres and increases the tactile sensibility. It is seen that Ksheeradhooma is having good efficacy on Ardita. Keywords: Ardita, Ksheera dhooma, bell’s Palsy

scholarly journals Peripheral nerve involvement in Bell's palsy

1984 ◽  
Vol 42 (4) ◽  
pp. 341-345 ◽  
Author(s):  
J. A. Bueri ◽  
L. G. Cohen ◽  
Marcela E. Panizza ◽  
Olga P. Sanz ◽  
R. E. P. Sica
Keyword(s):  
Peripheral Nerve ◽  
Facial Nerve ◽  
Motor Nerve ◽  
Bell’S Palsy ◽  
Bell's Palsy ◽  
Motor Nerve Conduction ◽  
Nerve Involvement ◽  
Peripheral Nerve Involvement ◽  
Conduction Velocities ◽  
The Right

A group of patients with Bell's palsy were studied in order to disclose the presence of subclinical peripheral nerve involvement. 20 patients, 8 male and 12 female, with recent Bell's palsy as their unique disease were examined, in all cases other causes of polyneuropathy were ruled out. Patients were investigated with CSF examination, facial nerve latencies in the affected and in the sound sides, and maximal motor nerve conduction velocities, as well as motor terminal latencies from the right median and peroneal nerves. CSF laboratory examination was normal in all cases. Facial nerve latencies were abnormal in all patients in the affected side, and they differed significantly from those of control group in the clinically sound side. Half of the patients showed abnormal values in the maximal motor nerve conduction velocities and motor terminal latencies of the right median and peroneal nerves. These results agree with previous reports which have pointed out that other cranial nerves may be affected in Bell's palsy. However, we have found a higher frequency of peripheral nerve involvement in this entity. These findings, support the hypothesis that in some patients Bell's palsy is the component of a more widespread disease, affecting other cranial and peripheral nerves.

scholarly journals Review of physical methods in the treatment of Bell’s palsy

2021 ◽  
Vol 10 (1) ◽  
pp. 13-17
Author(s):  
Wanda Stryła ◽  
◽  
Agata Kaczmarek ◽  
Keyword(s):  
Heat Treatment ◽  
Facial Expressions ◽  
Bell’S Palsy ◽  
Nerve Damage ◽  
Common Condition ◽  
Bell's Palsy ◽  
Physical Methods ◽  
The Face ◽  
Comprehensive Rehabilitation ◽  
Convalescence Time

Peripheral facial nerve damage is the most common condition of all cranial nerve damage; this nerve innervates the face in motor, sensory and parasympathetic ways. Bell’s palsy prevents patients from functioning normally by disturbing the speech function, eating and facial expressions. It can also lead to severe infl ammation of the eyeball and consequently to blindness. The study focuses on the influence of appropriately selected physical procedures on the time over which facial palsy affects a patient. The use of therapeutic methods such as: electrotherapy, heat treatment, facial massage, kinesitherapy and fi llers were also presented Comprehensive rehabilitation therapy based on the cooperation of doctors, physiotherapists and cosmetologists signifi cantly improves the results of pharmacological treatment and shortens convalescence time.

scholarly journals Tinjauan Anatomi Klinik dan Manajemen Bell's Palsy

2017 ◽  
Vol 1 (02) ◽  
Author(s):  
Nur Mujaddidah
Keyword(s):  
Facial Nerve ◽  
Healing Process ◽  
Bell’S Palsy ◽  
Acute Onset ◽  
Nerve Function ◽  
Facial Muscle ◽  
Facial Nerve Function ◽  
Bell's Palsy ◽  
The Face ◽  
Associated Abnormalities

Bell's Palsy is a peripheral facial nerve weakness (facial nerve) with acute onset on one side of the face. This condition causes the inability of the patient to move half of his face consciously (volunter) on the affected side. The Bell's Palsy incidence is 20-30 cases out of 100.000 people and accounts for 60-70% of all cases of unilateral facial paralysis. The disease is self-limited, but causes great suffering for patients who are not treated properly. Controversy in the management is still debated, and the cause is still unknown. The underlying hypothesis is ischemic, vascular, viral, bacterial, hereditary, and immunologic. Therapy done so far is to improve facial nerve function and healing process. The management of the therapy used will be closely related to the structure of the anatomy and its functions and associated abnormalities. The modalities of Bell's Palsy therapy are with corticosteroids and antivirals, facial exercises, electrostimulation, physiotherapy and decompression operations. Approximately 80-90% of patients with Bell's palsy recover completely within 6 months, even in 50-60% of cases improved within 3 weeks. Approximately 10% experienced persistent facial muscle asymmetry, and 5% experienced severe sequelae, and 8% of cases were recurrent.

Hemispheric Mechanisms Controlling Voluntary and Spontaneous Facial Expressions

1990 ◽  
Vol 2 (3) ◽  
pp. 239-245 ◽  
Author(s):  
Michael S. Gazzaniga ◽  
Charlotte S. Smylie
Keyword(s):  
Facial Expressions ◽  
Left Hemisphere ◽  
Cerebral Hemisphere ◽  
Right Hemisphere ◽  
Voluntary Movements ◽  
Optical Disc ◽  
Facial Muscles ◽  
The Face ◽  
The Right ◽  
Hemispheric Mechanisms

The capacity of each disconnected cerebral hemisphere to control a variety of facial postures was examined in three split-brain patients. The dynamics of facial posturing were analyzed in 30-msec optical disc frames that were generated off videotape recordings of each patient's response to lateralized stimuli. The results revealed that commands presented to the left hemisphere effecting postures of the lower facial muscles showed a marked asymmetry, with the right side of the face sometimes responding up to 180 msec before the left side of the face. Commands presented to the right hemisphere elicited a response only if the posture involved moving the upper facial muscles. Spontaneous postures filmed during free conversation were symmetrical. The results suggest that while either hemisphere can generate spontaneous facial expressions only the left hemisphere is efficient at generating voluntaly expressions. This contrasts sharply with the fact that both hemispheres can carry out a wide variety of other voluntary movements with the hand and foot.

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