The post What Is Bell’s Palsy? What Causes Bell’s Palsy? appeared first on Rehab Experts.
]]>A person might have Bell’s Palsy first thing in the morning – they wake up and find that one side of the face does not move. If an eyelid is affected, blinking might be difficult.
Bell’s Palsy usually starts suddenly.
Most people who suddenly experience symptoms think they are having a stroke. However, if the weakness or paralysis only affects the face it is more likely to be Bell’s palsy.
Neurology / Neuroscience News Section
Bell’s palsy is named after Charles Bell, a Scottish anatomist who first described it in 1821, and published his findings in a Royal Society paper entitled “On the Nerves: Giving an Account of some Experiments on Their Structure and Functions, Which Lead to a New Arrangement of the System”.
According to Medilexicon’s medical dictionary, Bell’s palsy is “paresis or paralysis, usually unilateral, of the facial muscles, caused by dysfunction of the seventh cranial nerve; probably due to a viral infection; usually demyelinating in type.”
The facial nerves control blinking, opening and closing of the eyes, smiling, salivation, lacrimation (production of tears), and frowning. They also supply the stapes muscles with nerves. The stapes is a bone in the ear which is involved in our ability to hear. When the facial muscle malfunctions, the following symptoms may emerge – symptoms of Bell’s palsy:
The facial nerve controls most of the muscles in the face and parts of the ear. The facial nerve goes through a narrow gap of bone from the brain to the face. This nerve becomes inflamed.
We are not completely certain what the cause of Bell’s palsy is.
A virus – experts believe it is most likely caused by a virus, usually the herpes virus, which inflames the nerve. The herpes virus is the one that also causes cold sores and genital herpes. Other viruses have also been linked to Bell’s palsy, including the chickenpox and shingles viruses, which are both related to the herpes virus. The virus that causes mononucleosis (Epstein-Barr) as well as the cytomegalovirus have also been linked to Bell’s palsy. Lyme disease in areas where it is endemic may be a principal cause of Bell’s palsy type symptoms caused by bacteria.
If the nerve is inflamed it will press against the cheekbone or may pinch in the tight corridor (narrow gap of bone) – this can result in damage to the protective covering of the nerve.
If the protective covering of the nerve becomes damaged, the signals which are being sent from the brain to the muscles in the face may not be transmitted properly, leading to weakened or paralyzed facial muscles – Bell’s palsy.
Diagnosing by a process of elimination (diagnosis of exclusion)
The doctor will look for evidence of other conditions which may be causing the facial paralysis, such as a tumor, Lyme disease, or stroke. This will involve checking the patients head, neck and ears. He/she will also check the facial muscles carefully and determine whether any other nerves are affected apart from the facial nerve.
If there is a change in facial structure it could be evidence of a tumor. A characteristic rash may be evidence of tick bites in Lyme disease.
If all other causes can be excluded, the doctor will diagnose Bell’s palsy. If the doctor is still unsure, the patient may be referred to an ENT (ear, nose and throat) specialist – an otolaryngologist. The specialist will examine the patient and may also order the following tests:
It is important to stress that the vast majority of patients with Bell’s palsy make a full recovery. However, if damage to the facial nerve is severe some complications are possible, including:
In the first couple of days to a week after symptoms start, your physical therapist will evaluate your condition, including:
Your physical therapist will immediately:
The first priority is to protect your eye. The inability to completely and quickly close your eye makes the eye vulnerable to injury from dryness and debris. Debris can scratch the cornea—the transparent front part of the eye that covers the iris, pupil, and front chamber of the eye—and could permanently harm your vision. Your physical therapist will immediately show you how to protect your eye, such as:
If you have partial facial movement, your therapist will teach you a few general facial exercises to do at home. These exercises will help you learn to move the weak side of your face and help you use both sides of your face together. One of the exercises is a gentle blowing action through your lips.
Your physical therapist will help you regain the healthy pattern of movements that you need for facial expressions and function. Recovery can be challenging because:
Your physical therapist will be your coach throughout this challenging time, guiding you through special exercises that are designed to help you relearn facial movements based on your particular movement problems. Your exercises may change over the course of recovery:
“Initiation” exercises. In the early stages, when you might have difficulty producing any facial movement at all, your therapist will teach you exercises that cause (“initiate”) facial movement. Your therapist will show you how to position your face to make it easier to move (called “assisted range of motion”) or how to “trigger” the facial muscles to do what you want them to do.
“Facilitation” exercises. Once you’re able to initiate movement of the facial muscles, your therapist will design exercises to increase the activity of the muscles, strengthen the muscles, and improve your ability to use the muscles for longer periods of time (“facilitate” muscle activity).
Movement control exercises. Your therapist will design exercises to:
To work on coordinating your facial muscles, you’ll need to have a sufficient level of activation of facial muscles first. Your therapist will determine when you’re ready.
Relaxation.During recovery, you might have facial spasms or twitches. Your physical therapist will design exercises to reduce this unwanted muscle activity. The therapist will teach you how to recognize when you are activating the facial muscle and when the muscle is at rest. By learning to contract the facial muscle forcefully and then stop, you will be able to relax your facial muscles at will and decrease twitches and spasms.
Some people might have greater difficulty moving their face after a period of improvement in facial movement, which can make them worry that the facial paralysis is returning. However, actual recurrence of facial paralysis of the Bell Palsy type is uncommon.
New difficulty in moving the face is more likely the result of increasing the strength of the facial muscles without improving the ability to coordinate and control the movement. To keep this from happening, your physical therapist will show you what facial movements you should avoid during recovery. For instance, the following might lead to abnormal patterns of facial muscle use:
Your therapist will coach you to use your face as naturally as possible, without trying to restrict facial expressions because they look “different.”
Reference:
Medical News Today http://www.medicalnewstoday.com/articles/158863.php
Move Forward http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=96135873-1b28-48bc-8be7-7d05c334daf1
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The post What Is Bell’s Palsy? What Causes Bell’s Palsy? appeared first on Rehab Experts.
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