scholarly journals Epidemiological Study of Bell's Palsy in patients From Western Nepal

2020 ◽  
Vol 2 (2) ◽  
pp. 41-46
Author(s):  
Krishna Prasad Koirala

 Background: Bell's palsy is defined as idiopathic, sudden onset, unilateral lower motor neuron facial paralysis. The etiology of Bell's palsy is unclear. It affects all age ranges with complete recovery in most cases. However, few patients are left with a considerable permanent functional deficit. The disease has variable progression ranging from few hours to days. Diagnosis is usually made when a patient presents with sudden onset unilateral lower motor neuron facial paralysis without an obvious cause. Different medical therapies such as steroids, antivirals, physiotherapy, acupuncture, etc. have been used to enhance the recovery of Bell's palsy. This study aims to find out the common age of presentation of people with Bell's palsy, and also to report their outcome with the use of steroids. Materials and methods: This study is a prospective observational study carried out in the department of ENT and Head and neck surgery at Manipal College of Medical Sciences, Pokhara, Nepal. Patients of all ages and both sex with the diagnosis of Bell's palsy meeting the inclusion criteria were studied from 1st Jan 2015 to 31st Dec 2018. Data were taken and analyzed with the help of SPSS software and results were published. Results: Out of 45 patients of Bell's palsy enrolled in the study, females outnumbered the males. Bell's palsy was more commonly seen in young adults There was a significant short-term improvement in Bell's palsy with the use of steroids (p=0.00001). There was no difference in early recovery after Bell's palsy regardless of the time of presentation within a week or age of the patient at presentation. Conclusion: Bell's palsy is more common in young adults. Steroids have a definite role in the short-term improvement of facial nerve function. People presenting within a week of facial nerve palsy can be treated with steroids. People of all ages can equally improve with steroid treatment.

2021 ◽  
Vol 6 (2) ◽  
pp. 143
Author(s):  
Rohmania Setiarini

Bell’s palsy merupakan kelainan saraf fasialis yang paling banyak dijumpai. Gejala klinis bell’s palsy yaitu adanya lesi saraf fasialis akut tipe lower motor neuron yang terjadi secara tiba-tiba dan cepat. Sekitar 80% pasien sembuh spontan. Etiologi dan patofisiologi masih diperdebatkan. Kehamilan memiliki resiko tiga kali lipat terjadi bell’s palsy. Penegakkan diagnosis berdasarkan klinis. Terapi yang direkomendasikan yaitu pemberian steroid oral. Artikel ini merupakan sebuah studi pustaka.Kata kunci: Bell’s palsy, etiologi, diagnosis, penatalaksanaan ABSTRACTBell's palsy is the most common facial nerve disorder. The clinical symptom is acute lower motor neuron type facial nerve lesion that occurs suddenly and rapidly. About 80% of patients recover spontaneously. The etiology and pathophysiology are still being debated. Pregnancy has a threefold risk of developing Bell's palsy. Diagnosis based on clinical. The recommended therapy is oral steroid administration. This article was a literature review.Keyword: Bell’s palsy, diagnosis, etiology, treatment


1995 ◽  
Vol 104 (7) ◽  
pp. 574-581 ◽  
Author(s):  
Toshiaki Sugita ◽  
Yasuo Fujiwara ◽  
Shingo Murakami ◽  
Yoshinari Hirata ◽  
Naoaki Yanagihara ◽  
...  

We have been the first to succeed in producing an acute and transient facial paralysis simulating Bell's palsy, by inoculating herpes simplex virus into the auricles or tongues of mice. The KOS strain of the virus was injected into the auricle of 104 mice and the anterior two thirds of the tongue in 30 mice. Facial paralysis developed between 6 and 9 days after virus inoculation, continued for 3 to 7 days, and then recovered spontaneously. The animals were painlessly sacrificed between 6 and 20 days after inoculation for histopathologic and immunocytochemical study. Histopathologically, severe nerve swelling, inflammatory cell infiltration, and vacuolar degeneration were manifested in the affected facial nerve and nuclei. Herpes simplex virus antigens were also detected in the facial nerve, geniculate ganglion, and facial nerve nucleus. The pathophysiologic mechanisms of the facial paralysis are discussed in light of the histopathologic findings, in association with the causation of Bell's palsy.


2021 ◽  
Vol 10 (20) ◽  
pp. 1551-1554
Author(s):  
Vrushali K. Athawale ◽  
Dushyant P. Bawiskar ◽  
Pratik Arun Phansopkar

Facial nerve palsy is the disease of cranial nerve. From the total number of cases, 60 to 75 % of Bell's palsy cases are idiopathic form of facial palsy. Facial nerve palsy results in weakness of facial muscles, atrophy, asymmetry of face and also disturbs the quality of life. Bell’s palsy occurs in every class of population affecting people of all the age groups but the most common age group affected is 15 - 50 years with equal sex prediliction accounting 11 - 40 cases per 100,000. If facial palsy is not treated properly then it may result in variety of complications like motor synkinesis, dysarthria, contractures of facial muscles, and crocodile tear. Currently facial paralysis treatment consists of combination of pharmacological therapy, facial neuromuscular re-entrainment physiotherapy or surgical intervention by static and dynamic facial reanimation techniques. Physiotherapy treatment is effective for treating facial paralysis with minimal complications and can be individualized. Bell's palsy is the idiopathic form of facial nerve palsy which accounts for 60 to 75 % of cases and male to female ratio is 1:3.1 The aetiology of facial paralysis is not yet thoroughly understood. Cases of varicella-zoster, mononucleosis, herpes simplex virus, mumps and measles have demonstrated good serology in several reports for their association but still stands unclear. 2 Peripheral facial nerve palsy may be idiopathic (primary cause) or Bell’s palsy (secondary). Causes of the secondary unilateral facial nerve palsy are diabetes, stroke, Hansen's disease, herpes simplex infection, birth injury, trauma, tumour, Guillain-Barre syndrome, and immune system disorders. Causes of the bilateral facial nerve palsy are leukemia, brainstem encephalitis, leprosy, and meningitis. The most prominent current theories of facial nerve paralysis pathophysiology include the reactivation of herpes simplex virus infection (HSV type 1). Current facial paralysis treatment consists of a combination of pharmacological therapy, facial neuromuscular re-entrainment physiotherapy or surgical intervention by dynamic and static facial reanimation techniques.7 This is a diagnosed case of right facial nerve palsy which was treated under physiotherapy department with proper rehabilitation protocol.


2019 ◽  
Vol 34 (14) ◽  
pp. 891-896 ◽  
Author(s):  
Elif Karatoprak ◽  
Sila Yilmaz

Objectives: The aim of the study was to determine the prognosis of children with Bell’s palsy and analyze the prognostic factors affecting early recovery. Methods: The records of children with a diagnosis of Bell’s palsy were retrospectively analyzed. Demographic and clinical features including age, gender, House-Brackmann Facial Nerve Grading System House-Brackmann Grading Scale (HBGS) grade at admission and follow-up, and the dosage and onset of steroid treatment were reviewed. Laboratory findings such as red blood cell distribution width and neutrophil-to-lymphocyte ratio were noted. The patients who were recovered within the first month (early recovery) were compared with the patients who were recovered after first month (late recovery) in terms of demographic, clinical characteristics, laboratory findings and treatment modalities in order to determine the risk factors affecting early recovery. Results: A total of 102 children (65 girls and 37 boys) with a mean age of 10.37 ± 4.2 years were included in the study. The complete recovery was detected in 101 children (%99) with Bell’s palsy. Statistically significant difference was found in terms of dosage and time of onset of steroid treatment ( P = .04, P = .035, respectively) and House-Brackmann Facial Nerve Grading System grade on the 10th day ( P = .001) between the early and late recovery groups. Conclusion: The prognosis of Bell’s palsy in children was very good. The prognostic factors affecting the early recovery were being House-Brackmann Facial Nerve Grading System grade 2 or 3 on the 10th day and receiving steroid treatment in the first 24 hours. Neutrophil-to-lymphocyte ratio and red blood cell distribution width were not found to be predictive factors for early recovery.


2020 ◽  
Vol 2 (1) ◽  
pp. 52-55
Author(s):  
Rajnish Kumar Thakur ◽  
Jagat Narayan Rajbanshi ◽  
Samjhana Khadka ◽  
Pankaj Raj Nepal

Background and purpose: Bell’s palsy represents sudden onset of lower motor neuron type of facial palsy in the absence of other cranial nerve involvement. Pathophysiologically, it has been described mostly due to viral infection, and early use of antiviral therapy, steroids and physiotherapy has shown to limit the disease and helps in early recovery from palsy. With the objective to evaluate over all clinical outcome of the patients presented with Bell’s palsy with our treatment strategies this study was performed. Material and method: This is a prospective analytical study with non probability consecutive sampling technique over the duration of 6 months. Continuous variable like age is presented using mean and standard deviation. Categorical data are presented as percentage and analysis of outcome of the treatment is done using Fischer’s exact test. Statistical analysis was done using SPSS -20. Result: Total number of patients enrolled in the study was 19, where mean age was 33.47 (SD 15.71) years. Bell’s palsy was more commonly seen in female patients (58%). House Brackmann grading of facial nerve palsy at the time of presentation was four. There was significant association of early treatment with complete recovery in this study. Conclusion: Early treatment of bells palsy with acyclovir, steroids, and physiotherapy has shown promising result in most of the studies; and this holds true in this study as well, where delaying the treatment was significantly associated with poorer recovery.


PEDIATRICS ◽  
1972 ◽  
Vol 49 (1) ◽  
pp. 102-109
Author(s):  
John J. Manning ◽  
Kedar K. Adour

In any instance of facial paralysis in a child, an effort should be made to determine immediately whether it is caused by a specific, treatable entity. Of 61 cases of facial paralysis in children seen in a Facial Paralysis Clinic, 38% were not Bell's palsy. Eight of the 61 children had disease amenable to specific therapy available today. Experience with 504 patients of all age groups seen within 4 years has led the authors to abandon facial nerve decompression in the treatment of Bell's palsy.


1988 ◽  
Vol 97 (6_suppl3) ◽  
pp. 14-17 ◽  
Author(s):  
Naoaki Yanagihara ◽  
Shinji Kitani ◽  
Kiyofumi Gyo

Combined measurements of reflexive lacrimation, stapedial reflex, and electrically induced taste give an indication of the site and extent of infratemporal lesions of the facial nerve. Using refined test batteries, we established the presence of intratemporal lesions in Bell's palsy in 80 patients with facial paralysis. In the acute stage of Bell's palsy, suprastapedial lesions predominated and the occurrence of a suprageniculate lesion was not rare. In the subacute stage, the lesions proximal to the stapedial nerve tended to subside and infrastapedial lesions increased. In 60% of 53 patients with denervation verified by electrodiagnostic examinations, the suprastapedial lesion was responsible for degeneration of the nerve. In the other 40%, degeneration involved the infrastapedial segment.


2020 ◽  
Vol 26 (4) ◽  
pp. 39
Author(s):  
Margaux Fricain ◽  
Nathan Moreau

Introduction: In the midst of the COVID-19 pandemic, there are numerous reports of SARS-CoV-2-related symptoms in many medical subspecialties. Unfortunately, there seems to be little focus on indirect victims of COVID-19, such as diseases/ailments secondary to COVID-19-related lockdown in relevant countries. Observation: We report a case of idiopathic facial paralysis (Bell's Palsy) that occurred in an otherwise-healthy 49-year-old French chef during nationwide lockdown, possibly fostered by severe concerns regarding his professional prospects. Other manifestations of severe anxiety were also observed such as tension-type headache and psoriasis outbreaks. Prednisone and valaciclovir were initiated, in association with simple counselling. Commentary and conclusion: As HSV-1 reactivation in the facial nerve is suspected in the pathophysiology of idiopathic facial paralysis, this case could constitute an example of lockdown-related disease and an illustration of indirect manifestations of the COVID-19 pandemic. Such indirect diseases are likely to increase as the pandemic continues to take its toll both medically and socio-economically.


2009 ◽  
Vol 123 (11) ◽  
pp. 1193-1198 ◽  
Author(s):  
R C van de Graaf ◽  
F F A IJpma ◽  
J-P A Nicolai ◽  
P M N Werker

AbstractBell's palsy is the eponym for idiopathic peripheral facial paralysis. It is named after Sir Charles Bell (1774–1842), who, in the first half of the nineteenth century, discovered the function of the facial nerve and attracted the attention of the medical world to facial paralysis. Our knowledge of this condition before Bell's landmark publications is very limited and is based on just a few documents. In 1804 and 1805, Evert Jan Thomassen à Thuessink (1762–1832) published what appears to be the first known extensive study on idiopathic peripheral facial paralysis. His description of this condition was quite accurate. He located several other early descriptions and concluded from this literature that, previously, the condition had usually been confused with other afflictions (such as ‘spasmus cynicus’, central facial paralysis and trigeminal neuralgia). According to Thomassen à Thuessink, idiopathic peripheral facial paralysis and trigeminal neuralgia were related, being different expressions of the same condition. Thomassen à Thuessink believed that idiopathic peripheral facial paralysis was caused by ‘rheumatism’ or exposure to cold. Many aetiological theories have since been proposed. Despite this, the cold hypothesis persists even today.


1989 ◽  
Vol 101 (4) ◽  
pp. 442-444 ◽  
Author(s):  
Malcolm D. Graham ◽  
Jack M. Kartush

Recurrent facial paralysis (RFP) is a rare disorder that in some individuals may lead to worsening sequelae. Melkersson-Rosenthal syndrome is a variant of RFP that is associated with recurrent facial edema. In the past, decompression of the mastoid segment of the facial nerve has not been successful in preventing recurrences. In 1981 we began performing total facial nerve decompression for RFP and in 1986 reported its efficacy in one patient with Melkersson-Rosenthal syndrome and in another in whom both nerves were decompressed for alternating bilateral paralysis. An additional four cases with 3 to 8 years of followup demonstrate no recurrences in any patient. Total facial nerve decompression for RFP in selected patients appears efficacious in preventing recurrences. Decompression will remain investigational until further followup is obtained. Furthermore, its salutary effect should not be extrapolated to Bell's palsy without further Study.


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