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Saturday 26 September 2020

Bell's palsy (Antoni's Palsy)

                                            Bell's palsy 





Synonyms of Bell's palsy:


-Antoni's Palsy

-Facial nerve palsy

-Facial Paralysis

-Idioopathic facial Palsy

-Refrigeration Palsy

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  The term facial palsy generally refers to the weakness of the facial muscles, mainly resulting from temporary or permanent damage to the facial nerve. 

Sudden weakness in the muscle on one half of the face. Bell's palsy may be a reaction to a viral infection, it rarely occurs more than once. Bell's palsy is characterized by muscle weakness that causes one half of the face to droop. 


 When a facial nerve is either non-functioning or missing, the muscles in the face do not receive the necessary signals in order to function properly. This results in paralysis of the affected part of the face, which can affect the movement of the eye's or mouth, as well as other areas. 


 There are different degrees of facial paralysis, sometimes only the lower half of the face is affected, sometimes one whole side of the face is affected and in some cases, both sides of the face are affected. 


Facial nerve

  Each side of the face its own facial nerve, so damaging the left facial nerve will only affect the left side of the face vice versa. Each nerve starts at the brain and enters the face to the front of the ear where it then divides into five separate branches. These branches supply the muscles which are used for facial expression. Tears, saliva production, and taste are also controlled by the facial nerve in different ways.


Functions of facial muscles perform:

 -Raising the eyebrows

- Closing the eyes

- Frowning

- Open mouth smiling 

- Closed mouth smiling

- Pouting

- Lifting top lip

- Pulling lower lip down

- Sticking bottom lip out

- Pulling jaw and corners of the mouth gently down

- Wrinkling nose


Facial palsy affect people:

 There are many different symptoms that can be associated with facial palsy. It is also often mistakenly assumed that the issues faced by people with facial palsy are purely cosmetic, but in reality, they experience a wide range of problems: 

- Facial palsy symptoms

- Physical issues

- Emotional issues 

Symptoms




- Rapid onset of mild weakness to total paralysis on one side of your face, occurring within hours to days. 

- Facial droop and difficulty making facial expressions, such as closing your eye or smiling 

- Pain around the jaw or in or behind your ear on the affected side 

- Drooling 

- Increased sensitivity to sound on the affected side

- Headache 

- A loss of taste

- Changes in the amount of tears and saliva you produce


Causes

- Cold sores and genital herpes

- Chickenpox and shingles

- Infectious mononucleosis

- Respiratory illnesses

- Cytomegalovirus infections 

- German measles

- Mumps

- Flu

- Hand-foot-and-mouth disease

   The nerve that controls your facial muscles passes through a narrow corridor of bone on its way to your face. 

Risk factors:

 -Have an upper respiratory infection

- Pregnant, especially during the 3rd trimester, or the first week after giving birth

- Diabetes

 Recurrent attacks of Bell's palsy rare. In some of these cases, there's a family history of recurrent attacks. 

Classification:

There are three different kinds of facial nerve injury:

- First degree injury: When the facial nerve is just concussed or bruised ad recovers within eight weeks. 

- Second degree injury: Where the facial nerve is more severely damaged but still retained its outer layer. The nerve begins ti show the frist signs of recovery at baout four months as it slowly repairs itself at the rate of around one milimeter per day. 

- Third degree injury: When the facial nerve is more severley damaged, any recovery is much slower and always incomplete. Sometimes the nerve is completely severed and surgical repair is needed to restore facial function

Complications

  A mild case of Bell's palsy normally disappears within a month. Recovery from a more severe case involving total paralysis varies

- Irreversible damage to your facial nerve. 

- Abnormal regrowth of nerve fibers. This may result in involuntary contraction of certain muscles when you're trying to move others

- Partial or complete blindness of the eye that won't close due to excessive dryness and scratching of the clear covering of the eye. 


Diagnosis


 There no specific test for Bell's palsy. Your doctor will look at your face and ask you to move your facial muscles by closing your eyes, lifting your brow, showing your teeth, and frowning, among other movements. 


Other conditions

  Such as a stroke, infections, Lyme disease, and tumors, which can cause facial muscle weakness that mimics Bell's palsy. If the cause of your symptoms isn't clear, your doctor may recommend other tests, including: 


- Electromyography (EMG): This test can confirm the presence of nerve damage and determine its severity. An EMG measures the electrical activity of the muscle in response to stimulation and the nature and speed of the conduction of electrical impulses along a nerve. 

- Imaging scans: Magnetic resonance imaging(MRI) or computerized tomography(CT) may be needed on occasion to rule out other possible sourced of pressure on the facial nerve, such as a tumor or skull fracture. 

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