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Facial palsy

PARALYSIS OF CN.VII

What is Bells Palsy?


Bells Palsy (or facial palsy) is characterized by facial drooping on the affected half due to malfunction of the facial nerve (CN VII) ,which controls the muscles of the face. Bells palsy is the most common acute mononeuropathy (disease involving only one nerve), and is the most common cause of acute facial nerve paralysis. This paralysis is of the infranuclear/lower motor neuron type.

Bells palsy affects about 40,000 people in the united states every year. It affects approx. 1 person in 65 during a lifetime. It is 3 times more likely to affect a pregnant woman than a non-pregnant woman and it is common in young adults. The Bells smile is characterized by an asymmetry caused by paralysis of one side of the face.

Pathology
As a result of inflammation of the facial nerve, pressure is produced on the nerve where it exits the skull within its bony canal, blocking the transmission of neural signs. Patients with facial palsy in which the cause is not known are not generally considered to have Bells palsy per se. These underlying problems could be tumor, stroke, meningitis, diabetes mellitus, head trauma and inflammatory diseases of the cranial nerves (sarcoidosis, brucellosis ,etc.)

Diagnosis And Treatment


Diagnosis- Bells palsy is a diagnosis of exclusion; in many cases, no specific cause can be ascertained Treatment- In patients with incomplete facial palsy, where the prognosis for recovery is very good, treatment may be unneccesary. However, patients presenting with complete paralysis, marked by an inability to close the eyes and mouth on the involved side, are usually treated with anti-inflammatory corticosteroids. Prednisolone and acyclovir are used in treatment In most cases, the paralysis will just improve with time, regardless of medication.

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