Bells palsy

2. INTRODUCTION
• Bell's palsy is the most common
acute mononeuropathy (diseas
e involving only one nerve) and
is the most common cause of
acute facial nerve paralysis
resulting from a dysfunction of
the cranial nerve VII (the facial
nerve).

3. DEFINITION
•Bell’s palsy (facial
paralysis) is due to
unilateral inflammation of
the seventh cranial nerve,
which results in weakness
or paralysis of the facial
muscles on the affected side

4. INCIDENCE
•IT CAN AFFECT ANY AGE
GROUP,BUT IT IS MORE
COMMONLY SEEN IN THE
20 TO 60 YEARS OLD AGE
RANGE.

5. ETIOLOGY
•IDIOPATHIC
•HERPEX SIMPLEX VIRUS
•VASCULAR ISCHEMIA
•AUTOIMMUNE DISEASE

6. PATHOPHYSIOLOGY
• The reactivation of the HSV
causes inflammation, edema,
ischemia and eventual
demyelination of the nerve,
creating pain and alteration in
motor and sensory functions.

7. CLINICAL MANIFESTATIONS
•Pain around and behind
the ear with fever, tinnitus
and hearing deficit.
•Face distortion and
flaccidity in the affected
side.

8. • Palpebral fissure: the opening
between the eyelids.
• Inability to smile, frown or
whistle.
• Unilateral loss of taste.
• Altered chewing ability.

9. Cont..
• Increased or decreased
lacrimation.
• Decreased blink reflex
• Speech difficulties
• Painful eye sensations
• Drooling
• Photophobia

10. Diagnostic Studies
•History and physical
examination
•Electromyogram (EMG)
•Nerve conduction test

11. Drug therapy
•Corticosteroids
Eg: prednisone
•Antiviral drug
eg: acyclovir
•NSAIDs
•Analgesics

12. Other therapy
• Physical therapy , electrical
stimulation to maintain muscle
tone.
• Eye care to maintain lubrication
and moisture if unable to close.
May need to be patched during
sleep

13. NURSING DIAGNOSIS
• Acute pain related to the
inflammation of CN VII
• Imbalanced nutrition less
than body requirements
related to inability to chew
secondary to muscle
weakness.

14. Cont..
• Risk for injury related to
inability to blink the eyes
• Disturbed body image related
to change in facial appearance
secondary to facial muscle
weakness.