What is Bell’s Palsy?
Bell’s Palsy is an idiopathic disorder that causes sudden, temporary weakness or loss of movement on one side of the face. While rare, it occasionally may affect both sides of the face . In some cases, it might affect the taste sensation at the front two-thirds of the tongue . The seventh cranial nerve, otherwise known as the facial nerve, is affected in this case. The nerve branches from the Fallopian canal and travels to the muscles of each side of the face. Hence, each facial nerve controls the movement of one side of the face . Typically, movements such as blinking the eye, smiling and frowning are affected in people with Bell’s Palsy.
People who suffer from this condition have the following symptoms :
- Difficulty in closing the affected eye
- “Drooping” of the corner of the mouth or the eye on the affected side
- Excessive tearing of the affected eye
- Loss of sensation on the affected side of face
- Loss of taste sensation
The approach to treating this condition involve conservative management and physiotherapy. Medications are prescribed accordingly to treat the cause of Bell’s Palsy, which may occur due to, for example, viral herpes infection, inflammation, and swelling . Patient education on proper care of the eyes and mouth will be helpful in preventing secondary problems such as dry eyes and gum disease .
Physiotherapy aims to facilitate the healing process through facial rehabilitation with facial exercises, electrotherapy, and the use of biofeedback . Lindsay and colleagues (2013) carried out a study on the effectiveness of facial rehabilitation in facial palsy patients. The study showed significant improvements in facial function among Bell’s Palsy patients after undergoing facial rehabilitation . This shows how important the role of facial rehabilitation is by preserving the properties of the facial muscles. Another similar study done by Cederwall and colleagues (2006) supported tailored exercise programs focusing on retraining the movement around the mouth, nose, face and forehead. This improved the regaining of symmetric movement and function of the affected area .Electrotherapy intervention, such as Electrical Muscle Stimulation, when integrated with facial exercises, is helpful in improving the quality of movement of the affected area. Mirror feedback and biofeedback are additional, useful facilitation methods to be integrated in the exercise program.
The current evidence supports early rehabilitation of Bell’s Palsy shows promising results in regaining the function of facial muscles, and enhancing the quality of life of patients, and should be undertaken as soon as possible.
1 Reginald,F.B., Gregory,J.B., and Lisa, E.I. (2013) Clinical Practice Guideline Bell’s Palsy. Sagepub [Online] Available at: http://journals.sagepub.com/doi/abs/10.1177/0194599813505967. [Accessed on 7th June 2017].
2 Swenson, R. (2008) Chapter 5: Facial sensations & movements. [Online] Available at: https://www.dartmouth.edu/~dons/part_1/chapter_5.html [Accessed on 7th June 2017].
3 National Institute of Neurological Disorders and Stroke, (2003) Bell’s Palsy Fact Sheet [Online] Available at: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Bells-Palsy-Fact-Sheet [Accessed on 7th June 2017].
4 Anne,C,P.,and Chalk,C. (2014) Bell’s palsy-topic overview. [Online] Available at: http://www.webmd.com/brain/tc/bells-palsy-topic-overview#1 [Accessed on 7th June 2017].
5 Nicastri,M., Mancini,P., and De Seta,D. (2013) Efficacy of Early Physical Therapy in Severe Bell’s Palsy A Randomized Controlled Trial. [Online] Available at: http://journals.sagepub.com/doi/abs/10.1177/1545968313481280 [Accessed on 7th June 2017].
6 Lindsay,R.W., Robinson,M., and Hadlock,T.A. (2010) Comprehensive facial rehabilitation improves function in people with facial paralysis: a 5-year experience at the Massachusetts Eye and Ear Infirmary. Phys Ther.90:391–397
7 Cederwall,E., Olsen,M.F.,Per Hanner and Fodgestam,I (2006) Evaluation of a physiotherapeutic treatment intervention in “Bell’s” facial palsy,Physiotherapy Theory and Practice Vol 22,Iss.1 .
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