Pebrian Bells Palsy for residen and dentistry student.pptx

for good description

1. P e brian D i ki Prestya P e mbimbing Prof. Dr. drg. H a rmas Yazid Yusuf, Sp.BMM, Subsp., TMT-TMJ(K) Bells Palsy Oral and Maxillofacial Surgery Dept. Faculty of Dentistry Padjdjaran University Bandung

2. DEFINITION Bell’s palsy ( facial paralysis ) is caused by unilateral inflammation of the seventh cranial nerve, which results in weakness or paralysis of the facial muscles on the affected side

3. INCIDENCE Younger than 45 years of age Men & women are affected equally

4. ANATOMY

5. CAUSES Although the cause is unknown, Theories about causes include Vascular ischemia, Viral disease (herpes simplex, herpes zoster), Autoimmune disease, a combination of all of these factors. Nerve trauma

6. RISK FACTOR

7. PATHOPHYSIOLOGY

8. CLINICAL MANIFESTATITON

9. CLINICAL MANIFESTATION

10. DIAGNOSIS EVALUATION History of the onset of symptoms is used to diagnose Bell’s palsy. Observation of the patient confirms the diagnosis. An EMG may be done. The possibility of a stroke must be ruled out.

11. House- Brackmann Classification of Facial Function

12. MANAGEMENT Corticosteroid therapy- to decrease inflammation ( eg , prednisone 1 mg/kg/day for 10 to 14 days Acyclovir combined with prednisone is possibly effective in improving facial function Eye care to maintain lubrication and moisture if unable to close. May need to be patched during sleep. Physical therapy, electrical stimulation to maintain muscle tone. Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics to relieve pain Heat application Massage Electrical stimulation

13. Test motor components of facial nerve (VII) by assessing patient's smile, ability to whistle, purse lips, wrinkle forehead, and close eyes. Observe for facial asymmetry. Observe patient's ability to handle secretions, food, fluids; observe for drooling. Assess patient's ability to blink and speak clearly. Assess effect of altered appearance on body image. Administer or teach patient to administer artificial tears and ophthalmic ointment as prescribed

14. COMPLICATION Corneal ulceration Impairment of vision Body image disturbance related to facial nerve paralysis

15. REFERENCES Zhang, W., Xu, L., Luo, T., Wu, F., Zhao, B., & Li, X. (2020). The etiology of Bell’s palsy: a review.  Journal of neurology ,  267 , 1896-1905. Singh, A., & Deshmukh, P. (2022). Bell's palsy: a review.  Cureus ,  14 (10). Dong, S. H., Jung, A. R., Jung, J., Jung, S. Y., Byun, J. Y., Park, M. S., ... & Yeo, S. G. (2019). Recurrent Bell's palsy.  Clinical Otolaryngology ,  44 (3), 305-312. Rajangam , J., Lakshmanan, A. P., Rao, K. U., Jayashree, D., Radhakrishnan, R., Roshitha , B., ... & Pravalika , K. H. (2024). Bell Palsy: Facts and Current Research Perspectives.  CNS & Neurological Disorders-Drug Targets (Formerly Current Drug Targets-CNS & Neurological Disorders) ,  23 (2), 203-214.

16. THANK YOU ORAL AND MAXILLOFACIAL DEPARTMENT PADJADJARAN UNIVERSITY 2024