Bell's palsy is a form of facial paralysis resulting from a dysfunction of the cranial nerve VII (the facial nerve)

that results in the inability to control facial muscles on the affected side. Several conditions can cause facial paralysis, e.g., brain tumor, stroke, and Lyme disease. However, if no specific cause can be identified, the condition is known as Bell's palsy. Named after Scottish anatomist Charles Bell, who first described it, Bell's palsy is the most common acute mononeuropathy (disease involving only one nerve) and is the most common cause of acute facial nerve paralysis. Bell's palsy is defined as an idiopathic unilateral facial nerve paralysis, usually self-limiting. The hallmark of this condition is a rapid onset of partial or complete palsy that often occurs overnight. In rare cases (1%), it can occur bilaterally resulting in total facial paralysis.

Risk Factors Viral meningitis or the common cold sore virus- herpes simplex virus Lyme disease Pregnant Influenza or flu like illness Chronic middle ear infection Headaches High blood pressure Diabetes Sarcoidosis Tumor Trauma such as skull fracture

Sign and symptoms Twitching Muscle weakness Paralysis on one or both sides of the face Drooling Dryness of the eye or mouth Impairment of taste Excessive tearing in one eye Pain or discomfort around the jaw and behind the ear Ringing in one or both ears Headache Loss of taste Impaired in speech Dizziness Difficulty in eating and drinking Facial swelling Overall droopy appearance Sensitivity to light

Asymmetrical smile

Medical Management Acyclovir Prednisone Analgesics Physical therapy Facial massage and exercises Moist heat applied to the affected side of the face Relaxation techniques Acupuncture Electrical stimulation Vitamin therapy (specially vitamin B12 and B6)

Surgical Management Decompression Surgery for Bells Palsy Cosmetic or Reconstructive Surgery

Complications Chronic loss of taste Chronic facial spasm Corneal spasm

Nursing Intervention Cover the eye with a protective shield at night Use tear like eye drops or eye ointments to prevent the eye from drying Taught the patient to close the paralyzed eye manually before going to sleep Advise the patient to wear eye glasses or sunglass during the day to decrease normal evaporation from the eye Perform facial exercises with the aid of a mirror to prevent muscle atrophy Exposure of the face to cold drafts is avoided Nurse can suggest massaging the face several times daily using gentle upward motion to maintain muscle tone