Jumat, 07 Maret 2014

Bell's Palsy: Facial Nerve Disorders




Bell 's Palsy is a disorder of the facial nerve that causes weakness or paralysis of the muscles suddenly on one side of the face .

Facial nerve is a cranial nerve that stimulates facial muscles .

CAUSE
The cause is unknown , but is thought to be swelling of the facial nerve in response to viral infection , suppression or reduced blood flow .

SYMPTOMS
Bell 's palsy occurs suddenly .
A few hours before the onset of weakness of the facial muscles, the patient may feel pain behind the ear . Muscle weakness that occurs can be mild to severe , but always on one side of the face .

The paralyzed side of the face to be flat and without expression , but the patient feels as if his face twisted .
Most people experience numbness or feel there is a load on her face , despite the fact sensation in the face is normal .

If the top of the face are also affected , the patient will experience difficulty in closing his eyes on the affected side .
Sometimes the disease affects the formation of saliva , tears or taste on the tongue .

Bell 's palsy Ptosis

Diagnosis
Diagnosis based on symptoms .
Bell 's palsy is always on one side of the face ; weakness occurs arrived - arrived and can involve either the top or bottom face .

Other diseases can also cause facial nerve paralysis are :
- Brain tumors are pressing on nerves
- Damage to the facial nerve due to viral infections ( eg, Ramsay Hunt syndrome )
- Infections of the middle ear or mastoid sinuses
- Lyme Disease
- Fractures at the base of the skull .
To distinguish Bell 's palsy with the disease , can be seen from the history of the disease , the results of X-ray , CT scan or MRI . In Lyme disease blood tests need to be done .
There is no specific test for Bell 's palsy .

TREATMENT
There is no specific treatment for Bell 's palsy .

Some experts believe that kortikoteroid ( eg, prednisone ) should be given in no more than 2 days after the onset of symptoms and continued for 1-2 weeks .
Is this treatment can reduce pain and improve the chance of cure , still has not been proven .

If the paralysis of facial muscles causes the eye can not be closed, the eyes should be protected from drought .
Lubricating eye drops are used every few hours .

In severe paralysis , massage the muscles weak and perangasangan nerves may help prevent the occurrence of facial muscle stiffness .

If the paralysis persists until 6-12 months or more , can be done surgically for transplanting healthy nerve ( usually taken from the tongue ) into the facial muscles are paralyzed .


Prognosis

If the partial paralysis ( in part ) , then the total healing occurs within 1-2 months .
Prognosis in total paralysis is varied , but most experienced complete healing .

To determine the likelihood of complete healing , can be performed to test the facial nerve using electrical stimulation .
Sometimes improved facial nerve , but forming a relationship that causes abnormal movements undesirable in some facial muscles or spontaneous discharge of tears .