Bell’s Palsy/Facial Palsy

CAUSES :

  • Varcella-Zoster virus.
  • Epstein-Barr viruses.
  • HIV infection
  • Lyme disease
  • Middle ear infection
  • Sarcoidosis
  • Trauma
  • Environmental factors
  • Metabolic or emotional disorders
  • Metabolic or emotional disorders
  • Myasthenia gravis
  • Viral infections such as herpes, mumps, influenza, a cold, infectious mononucleosis
  • Multiple sclerosis
  • Guillain-Barre Syndrome
  • Chronic disease such as diabetes
  • Tumor causing nerve compression
  • Stress
  • Pregnancy

SYMPTOMS :

  • Sometimes person may have a cold shortly before the symptoms of Bell’s palsy begin.
  • Symptoms most often start suddenly, but may take 2 – 3 days to show up. They do not become more severe after that.
  • Gripping and movements of the wrist hurt, especially wrist flexion.
  • Symptoms are almost always on one side only. They may range from mild to severe.
  • The face will feel stiff or pulled to normal side, and may look different.
  • Difficulty eating and drinking; food falls out of one side of the mouth.
  • Drooling due to lack of control over the muscles of the face.
  • Drooping of the face, such as the eyelid or corner of the mouth.
  • Hard to close one eye.
  • Problems smiling, grimacing, or making facial expressions.
  • Twitching or weakness of the muscles in the face.

Other symptoms that may occur:

  • Dry eye or mouth.
  • Headache.
  • Loss of sense of taste.
  • Twitching in face.
  • Sound that is louder in one ear (hyperacusis).

GOALS OF PHYSIOTHERAPY :

  • To maintain muscle tone of the affected facial muscles.
  • Muscle re-education exercises, useful in restoring normal movements.
  • To reduce flaccidity (in case of Bell’s palsy) &spasticity (in case of Facial Palsy).
  • Transcutaneous electrical stimulation for denervated facial muscles.
  • Soft tissue techniques are implemented prior to recovery in order to help prevent permanent contractures of the paralyzed facial muscles.
  • Taping technique.

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