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bell's palsy

Bell\'s palsy Bell\'s palsy is associate acute apperantly isolated ,lower neuron palsy caused by disfunction of nerve namly nervus facialis. Etiology (1) exposure to cold might precipitate bell\'s palsy (2)supurative otitis (3)herpes herpes zoster (4)head injury (5)dental physiological state (6)diabetes or high blood pressure (7)last trimenster of maternity (8)multiple pathology Clinical options Symptoms -sudden ,following exposure to relax or with none apparent causative cause -postauricular pain is common and it should precede palsy by two days -there is also spontaneous  complain of loss os sense of style,watering of eye and sweating less on affected facet  Signs -forhead cannot be wrinked -eye cannot be closed. On making an attempt closure .eyeball turns upward and outward(bells phenomena) -on showing teeth ,the lips don\'t separate on affected facet. Whisthling isn\'t doable -angle of mouth on affected facet droops with drribling of spittle -cheeks puffs out with experation  -food collected between teeth and paralysed cheek -fluid run out whereas drinking -base of tongue lowerd Investigation diagnostic procedure is conseder to beusefull to diagnose and prognose illness Managment (1)local heat- infrared or damp heat or radio wave modality over the face or salivary gland region if pain and tenderness is gift (2)local treatment of muscles -patient ought to recommendation to massage the striated muscle with blade oil double on a daily basis for chin and lower lip and will be directed upwar -muscle exercise ,patient ought to practise movement of varied muscles of face before a mirrior -for bar of facial slaging apply a strip of tape to elevate up the angle of mouth (3)protction of eye -wear dark glass or aply eye pouch -the eye ought to be washed double daily with gentle Zn boracic answer to forestall conjuctivitis (4)corticosteroids -prescribe tab Prelone ten mg  daily for four days to cut back secondary oeodema (5)galvanism -2 weeks once onset of palsy 3 times per week .do not offer if face is tendre,stop if involantory contractions of striated muscle devlops (6)surgery -if patient fails to recover once nine months once on top of treatment -anastomosis of facial with accesory or preferabaly hypoglossal is also done or cosmetic surgery just in case of total palsy with atrophy of muscular structure

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