BELL’S PALSY

PRESENTED BY DR MAIMUNA MUHAMMAD IBRAHIM

OBJECTIVE
S:
• DEFINTION
• INCIDENCE
• RISK FACTORS
• ETIOLOGY
• CLINIC PRESENTATION
• PATHOPHYSIOLOGY
• DIAGNOSTIC STUDIES
• MANAGEMENT
• COMPLICATION
 DEFINITI
ON
Bell’s Palsy or Acute facial nerve palsy is a condition that causes a temporary weakness or
paralysis of the muscles in the face. It can occur when the nerve that controls your facial
muscle become inflamed, swollen, or compressed.
INCIDENCE & PREVALENCE OF BELL'S PALSY:
• Bell's palsy affects about 40,000 people in the United States every year. It affects
approximately 1 person in 65 during a lifetime. Worldwide statistics indicate a frequency of
about .02% of the population.
• Bell's palsy is more commonly seen in young adults, and persons of Japanese descent have a
slightly higher incidence of the condition. Bell's palsy is the most common cause of facial
paralysis worldwide and one of the most common neurological disorders involving a cranial
nerve.
• Incidence of Bell's palsy in males and females, as well as in various races, is approximately
the same. The severity of the condition (e.g., mild, severe), and the rate of recovery also is
equal.
ETIOLO
GY
Idiopathic.
But is usually thought to be viral.
• Cold sores and genital herpes (herpes simplex)
• Chicken pox and shingles ( herpes zoster)
• HIV, cytomegalovirus
• Respiratory illnesses(adenovirus)
• Ebstein-Barr virus
• Lyme disease (bacterium borrelia burgdrferi)
• Vaccinations .
 CLINICAL
PRESENTATION
PATHOPHYSIOL
OGY
• Cranial Nerve VII (Facial Nerve)
Responsible for the following:
1.Muscle movements of facial
expressions
2.Anterior 2/3 of taste sensation on
The tongue
3.Involved in sound perception
4.Salivation and tear production
 DIAGNOSTIC
STUDIES
Diagnosis is usually clinical
Other conditions such as stroke, infections, lyme disease, inflammatory conditions and tumors
can cause facial muscle weakness that mimics Bell’s palsy. So other tests might be
recommended.

Electromyography (EMG): This test can confirm the presence of nerve damage and severity.
IMAGING SCANS: MRI OR CT may be needed to rule out other possible sources of
pressure on the facial nerve, such as a tumor or skull fracture.
BLOOD TESTS: Used to rule out Lyme disease and other infections.
CSF: Rarely done( mild CSF lymphocytosis may be present.
MANAGEME
NT
• Most people with Bell’s Palsy recover fully with or without treatment within weeks or
months.
• Steroids in the form of (Dexamethasone 2mg tds or Prednisolone 1mg/kg for 7 days) may
sometimes be helpful if patient presents within 48 hours of onset of symptoms.
• Evidence to support use of antivirals is limited, but acyclovir or valaciclovir is often given in
combination with steroids.
• Supportive treatment consist of protection of the eye during sleep, encourage pulling the
eyelids close by hand, dark glasses and artificial tears if evidence of drying, massage of
weakened muscles and a splint to prevent drooping of the lower part of the face.
• Cosmetic Surgery may be helpful where recovery is not complete.
COMPLICATIONS
A mild case of Bell’s Palsy normally disappears within a month, but recovery from a more
severe case involving total paralysis varies.
Complication may include:
• Irreversible damage to the facial nerve.
• Misdirected regrowth of nerve fibers, resulting in involuntary contraction of certain muscles
when you're trying to move others (synkinesis)
• Partial or complete blindness of the eye that wont close due excessive dryness and
scratching of the cornea.
 REFERENC
ES
• A Compendium of clinical medicine by A.O. Falase, O.O. Akinkugbe. Chapter 10, page 573- 573
• Oxford Handbook of Clinical Medicne. Chapter 10, page 500.
• Kumar & Clark’s Clinical Medicine eighth Edition by Parveen Kumar, Michael Clark.
• Center for NeurologicalTreatment & Research, http://www.neurocntr.com/bells-palsy.php
• https://youtu.be/VtB-YYeaeV

• https://www.mayoclinic.org/diseases-conditions/bells-palsy/diagnosis-treatment/drc-20370034

• Facial nerve electrodiagnostics for patients with facial palsy: a clinical practice guideline

• https://www.healthline.com/health/bells-palsy#outlook