what is Facial Palsy? facial palsy and lyme disease, causes facial palsy

What causess bell's palsy | Facial Palsy and lyme disease | Facial Palsy stroke | Exercise for facial palsy | facial paralysis | bell's palsy treatments | Types of facial palsy 

Introduction

Damage to the facial nerve (i.e. cranial nerve VII) that supplies the muscles of the face causes facial palsy. Based on the location of the casual pathology, it can be divided into two types: 

1:-Palsy of the central face 

Due to injury above the nucleus of the face. 

2:-Palsy of the peripheral face 

Due to injury below the nucleus of the face. 

The pons houses the nucleus of the facial nerve. Before departing the skull through the stylomastoid foramen, it travels a fairly circuitous trip. It then splits into five branches as it goes through the parotid gland.

· Temporal

· Zygomatic

· Buccal

· Mandibular

· Cervical

Causes

•Bell's Palsy or Idiopathic:- Face paralysis is caused by a variety of factors. 

Although the etiology is unknown, it is thought to be associated to Herpes Simplex infection.

•Tumor

•Infection:- Ramsay Hunt syndrome - caused by Herpes Zoster infection.

•Lyme disease - caused by infection with Borrelia burgdorferi via tick bites.

•Iatrogenic facial nerve damage

•Occurs most commonly in temporomandibular joint replacement, mastoidectomy and parotidectomy.

•Trauma:- Especially temporal and mastoid bone fractures mostly.

Rare causes, including:

· Otitis media

· Multiple sclerosis

· Guillain-Barre syndrome

 

Risk factors

· Diabetes

· Pregnancy

· Ear infection

· Upper respiratory tract infection

· Obesity

Diagnosis

Laboratory investigations include an:-

Audiogram.

Nerve conduction studies (ENoG).

Computed tomography (CT).

Magnetic resonance imaging (MRI).

Electromyography (EMG).

 

Differential Diagnosis

Other than Bell's Palsy, important differential diagnoses for a facial palsy include: 

 

UMN causes

A stroke, a subdural hematoma, or a brain tumor are examples of UMN causes. 

The will present with a shaved brow. 

 

LMN causes

LMN has a number of effects. 

Acute otitis media, cholesteatoma, and viral infection are examples of infectious diseases (including HSV-1, CMV, and EBV).

Neoplasm is a term used to describe a (parotid malignancy).

Iatrogenic or traumatic injury.

 

Management

Patient reassurance is critical, since most patients recover to full function on their own. One of the most crucial aspects of treatment is eye care, which includes ensuring that the patient uses lubricating drops on a regular basis and considering the use of eye ointment and/or an eye patch at night.

Oral steroids should be given to all patients who present within 72 hours after the onset of symptoms. According to current NICE recommendations, you should do one of the following: 

For ten days, take 25 mg twice a day. 

Giving 60 mg daily for five days, then a daily dose reduction of 10 mg 

The use of antiviral drugs is debatable.

 

Physiotherapy ( Exercise for facial palsy )

The most crucial thing to do in the early stages of facial palsy is to make sure that patients are properly caring for their damaged eye. Patients with facial palsy are more prone to experience dry eyes in the early weeks and months since the face nerve is crucial for producing lubricant for the cornea. As a result, they are at risk of getting a corneal ulcer, which can result in vision loss in the affected eye. 

 

If other medical personnel have not already done so, the therapist should educate the patient about dry eye management. An urgent referral to ophthalmology is required if the eye seems red or the patient describes repeated episodes of redness.

Treatments like these are included:

•Self-massage 

•Exercising your breathing and relaxing 

•Exercises to improve coordination and lessen synkinesis on both sides of the face. 

•Exercises to aid with the closing of the eyes and lips 

•Exercising using letters, words, and facial expressions.

Difference between Bell's palsy and Facial palsy?

Bell's palsy is characterized by inflammation of the facial nerve, which results in facial paralysis on the affected side. The most common acute disorder affecting only one nerve is facial nerve palsy, with Bell's palsy being the most prevalent cause of acute facial paralysis.