3. Overview
BELL'S PALSY IS A
CONDITION THAT CAUSES TEMPORARY WEAKNESS OR PARALYSIS OF
MUSCLES OF ONE SIDE OF THE FACE.
IT IS MOST COMMON CAUSE OF FACIAL PARALYSIS.
4. Causes:
> Congenital facial palsy
> Injury to the facial nerve in an accident
> Facial nerve damaged by
inflammation
> Herpes virus that causes cold sores
> Injury from surgery
Symptoms:
>Weakness or paralysis of one side of the face
that causes dropping of mouth of affected side
> Difficulty in closing the eyelid on affected
side
> Dryness or increased tear production from
the affected side of eye
> Earache
>An altered or reduce sense of taste
> Drooling from the mouth
> Pain around the jaw
> Headache and dizziness
>Tinnitus
> Dysphagia
> Impaired speech
5. Corticosteroids
Antivirals
Full recovery by most patients in 6
months, especially if treatment
is started immediately
Forehead not wrinkled
Eyelid does not close
Eyeball rolls up
Flat nasolabial fold
Paralysis of lower face
8. Role Of OccupationalTherapy:
•Facial Exercise :
Gross exercises typically given to patient
reinforce normal movement pattern. Instruction such as "try to
close your eye as hard as you can", "smile broadly", or "pucker your
lips".The use of maximum effort exercises recruits excessive motor
units.
There are certain exercises which are effective in the treatment of
Bell's palsy:
9. Role Of OccupationalTherapy: (cont.)
•TheV :
> Purpose: Good for dropping of eyelid, puffiness.
> Method: Press both middle finger together at the corner of the
eyebrows, then with the index fingers, apply pressure to the outer
corner of the eyebrows. Look to the ceiling, and raise the lower
eyelid. Repeat six more times and finish by squeezing eyes shut
tightly for 10 seconds.
10. Role Of OccupationalTherapy: (cont.)
•The Smile Smoother:
> Purpose: Good for cheek line and sagging skins
> Method: Hide the teeth with the upper lip to make an 'O' shape
with the mouth.Smile widely while keeping the teeth hidden and
repeat six times. Next, hold the smile shape while placing one
index finger on chin.Then start to move the jaw up and down as
the head tilt gently back. Relax and repeat twice more.
11. Role Of OccupationalTherapy: (cont.)
•SmoothThe Brow:
> Purpose: Good for horizontal forehead lines
> Method: Place both hand on the forehead facing inward and
spread all of the fingers out between the eyebrows and hairline.
Gently sweep the finger outwards across the forehead, applying
light pressure to tighten the skin. Relax and repeat 10 times.
12. Role Of OccupationalTherapy: (cont.)
•The Giraffe:
> Purpose: Lines & loose skin on the neck
> Method: Looking straight ahead, place the finger tip at the
bottom of the neck and lightly stroke the skin downwards with the
head tilted back. Bring the back down to the chest and repeat
twice more. Finally, jut the lower lip out as far as possible to pull
corner of the mouth down and place finger tips on the collarbone
with chin pointed upward. Hold for four deep breath.
13. Role Of OccupationalTherapy: (cont.)
•Non Invasive Modality For ManagementOf Drooling And
Swallowing:
Positioning: Good posture with proper trunk and head control
provides the basis for improving oral control of drooling and
swallowing.
Oral Prosthetic Device:Variety of prosthetic devices can be
beneficial, e.g. chin cup and dental appliances, to achieve
mandibular stability, better lip closure, tongue position and
swallowing. Cooperation and comfort of the patient is essential
for better results.
15. Role Of OccupationalTherapy: (cont.)
Oral Facial Facilitation: this technique will help to improve oral motor
control, sensory awareness and frequency of swallowing.This
technique can be practiced easily, with no side effects and can be
ceased if no benefits noted.
• Brushing- as effect can be seen up to 20- 30 minutes, suggested to undertake before meals.
• Icing – effect usually last up to 5-30 minutes. Improves tone, swallow reflex.
• Vibration- improves tone in high tone muscles.
• Manipulation – like tapping, stroking, patting, firm pressure directly to muscles using fingertips
known to improve oral awareness.
• Oral motor sensory exercise - includes lip and tongue exercises.
16. Role Of OccupationalTherapy: (cont.)
•Eye Protection:
Most important factor in bell's palsy is an
inability to close the eyelid of affected side, therefore eye become
dry most of the time and there is a risk of debris and injury.
Therefore, keeping the eye moist, especially at night, is important.
Lubricating eye drops and eye patches are more effective
treatment for Bell's palsy.
18. “
”
There are three critical roles for occupational therapy
practitioners in health promotion and disease or disability
prevention: to promote healthy lifestyles; to emphasize
occupation as an essential element of health promotion
strategies; and to provide interventions, not only with
individuals but also with populations. (p. 696)
According toOccupationalTherapy in the Promotion of Health and the Prevention of Disease and Disability (AOTA, 2008a),
OccupationalTherapy’s Role in Prevention andWellness
(Involvement in health promotion and disease or disability prevention program)
