Bell's Palsy ICIDH2 Purvi Shah PPT

Charles Bell describe Bell's Palsy. It's LNM lesion. paralysis of the facial muscle; loss of facial expression. Idiopathic in nature. Most of Patient recover from Bell's Palsy 20 to 25 days. #purvishah #Bell'sPalsyICIDH2Format.

1. -Purvi Shah ( B.P.T)

2. INTRODUCTION It is a most common neurologic disorders affecting 7th the facial nerve . Unilateral, peripheral facial paresis or paralysis without a detectable cause. Facial nerve affect just above stylomastoid foramen & produce BELL`S PALSY. It`s LMN lesion.

3. Etiology : Idiopathic Positive family history Clinical features : Maximum paralysis in 24 h Posterior auricular pain L oss of taste sensation W atering of eyes Sweating less on affected side loss of wrinkles in forehead

4. Bell’s Phenomenon : while attempting eye closure eye ball turn upward & outward On showing teeth lips do not separate on affected side Whistling is not possible Nasolabial fold flat Angle of mouth drops with dribbling of saliva Cheeks puff out Food collects between cheeks & teeth Heaviness in the face & loss of facial expression Crocodile tear occur due to annamulus nerve supply

5. ICIDH2 Format Impairment 1 . Structural Impairment A ffection of facial nerve above stylomastoid foramen A ffection of nerve to stapedius Affection of posterior auricular nerve Affection of nerve to digastric belly Affection of nerve to stylohyoid Affection of chorda tympani Affection of greater petrosal nerve Affection of zygomatic braches

6. I mpairment 2 . Functional impairment M aximum paralysis of whole face of the same side Hyperacusis Loss of taste sensation (anterior 2/3 rd part of tough) Loss of facial expression Loss of lacrimation Lack of salivation Difficulty in swallowing Flattering of nasolabial fold

7. Activity limitation Difficulty in swallowing Difficulty in facial movement Difficulty in smiling Difficulty in communication activities Difficulty in eye closure

8. Participation Restriction Restriction in area of education & work Restriction in familiar occasion

9. Contextual factor Personal factor A ge- 15 to 60 years G ender- Affect males & females equally R ace- Americans (whites>blacks)

10. Environmental factor Occupational exposure Social background

11. Investigation : Lab test (to rule out diabetes) CSF analysis (to rule out GBS) CT Scan & MRI (to rule out tumor) EDT : Minimal nerve excitability test Maximal stimulation test NCV

12. PHYSIOTHERAPY Local Heat (over nerve trunk) : SWD disc electrode method Massage : Kneading, Effleurage, superficial stroking US(over nerve trunk) ES : Ig current SF current Eye protection : wear dark glasses, wash eye zinc boric solution for prevention of conjunctivitis Visual feedback exercise

13. Electrical Stimulation

14. Massage

15. Exercises

16. Exercise : Tightly closure your eyelid Raise your eyebrow To make pout To puff out your face Bell’s palsy splint Strengthening exercise

17. Surgical Treatment : Facial nerve decompression Facial nerve grafting Tarsorrhaphy