BELL

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BELLS PALSY BY RANDY BONNELL
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Pathophysiology

• Actual pathophysiology is unknown
• A popular theory is the nerve increases in
  diameter and becomes compressed as it courses
  through the temporal bone.

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Frequency

• The incidence of Bell palsy in the United States
  is approximately 23 cases per 100,000 persons

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Clinical manifestations

• There is usually an abrupt onset of numbness or a
  feeling of stiffness or drawing sensation of the
  face
• The face appears asymmetric, with drooping of the
  mouth and cheek
• Other symptoms may be.

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More Clinical manifestations

• Loss of taste
• Reduction of saliva (on affected side)
• Pain behind the ear
• Ringing in the ear or other hearing loss
• Difficulty swallowing

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Race/Sex/Age

• Incidence of Bell palsy appears to be slightly
  higher in persons of Japanese descent
• No difference exists in sex distribution in
  patients with Bell palsy
• The incidence is highest in persons aged 15-45
  years

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Lab Studies

• No specific laboratory tests exist to confirm the
  diagnosis of Bell palsy

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Medical management

• There is no specific therapy for bells palsy.
• Electrical stimulation or warm moist heat along
  the course of the nerve may be helpful

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Nursing interventions

• Protection of the eye when the eyelid does not
  close
• Massage of the affected area is sometimes
  recommended
• Do face exercises ( closing eyes, puffing out
  cheeks, wrinkling the forehead)
• Keeping the affected eye moist

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Prognosis

• Prognostically, patients fall into 3 groups with
  roughly equal numbers in each group.
• Most patients develop an incomplete facial
  paralysis during the acute phase
• Of patients with Bell palsy, 85 achieve complete
  recovery

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The groups are.

• Group 1 regains complete recovery of facial motor
  function without sequelae
• Group 2 experiences incomplete recovery of facial
  motor function, but no cosmetic defects are
  apparent to the untrained eye
• Group 3 experiences permanent neurologic sequelae
  that are cosmetically and clinically apparent

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