Abstract
Bell’s palsy is a very interesting phenomenon that results in the damage of the facial nerve that controls the muscles of the face. The cause of it is uncertain however, it is considered to be an autoimmune disorder due to viral infections that cause muscle weakness and paralysis. Symptoms of Bell’s palsy include numbness to the face causing the face and eyelids to droop. Relies heavily on signs and symptoms and examination of physical condition by a doctor is highly recommended. Patients can be evaluated using Photoshop, ultrasound, and tests such as MRI, X-rays, and blood tests. Bell’s palsy patients can recover by medical treatments, facial phototherapy, laser therapy, botox, and in rare cases plastic surgery.
Introduction
Bell’s
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palsy was discovered in 1882 by a physician named Dr. Charles Bell. The palsy component of the term explains that there is neurological deficit or paralysis of a nerve function (Mooney, 2012). In patients with Bell’s palsy the facial nerve suddenly stops working causing the face to feel numb and the mouth to droop.
This is due to a problem with the facial nerve that allows the muscles of your face to conduct certain expressions and movements. The facial nerve extends from the brain stem to a narrow canal just behind the ear. The facial nerve supplies small muscles to the ear that are responsible for muffling the sounds we here. This nerve is also responsible for facial movements such as closing the eyelid, raising the eye brows, smiling, and moving the forehead. In addition, it is also responsible for taste sensation of the tongue and opening and closing of the mouth (see Figure 1, for visual anatomy of the facial nerve). Bell’s palsy is strictly localized to one half of the face in some extremely rare cases it can affect both sides of the face. The real cause of Bell’s palsy is not certain. It is considered to be due to an autoimmune disorder that causes the facial nerve to swell. It could also be due to a viral infection that causes muscle weakness and paralysis. However, the leading causes of Bell’s palsy may be shingles and herpes simplex virus that results in mouth infections like colds. Other viral causes of Bell’s palsy can be cytomegalo virus that causes herpes and coxsackie virus that causes disease of the mouth, hands, and feet. Also, viruses that are …show more content…
responsible for influenza, rubella, mumps, and mononucleosis and viral infections that lead to inflammation. If there is inflammation around the facial nerves, it can press the nerves causing them to completely or partially stop working. When the nerves stop functioning, the muscles associated with them also stop working. Hence, the facial muscles are weakened or paralyzed temporarily until the inflammation goes away and the nerves start functioning properly again. The signs and symptoms of Bell’s palsy appear suddenly and they include a heavy numb feeling on the face, facial droop, and difficulty in moving facial muscles during smiling and closing eyes. Sudden weakness or total paralysis on one side of the face occurs within hours to days. It also results in loss of taste, drooling, changes in salivation and tear production. It can also result in high sensitivity to sound on the affected side with a slight amount of pain in the ear, around the jaw, and can also cause the head to ache. The signs and symptoms of this disease show up suddenly, but in a few days, they intensify gradually. However, it’s not a progressive disease. Instead, it is steady paralysis that develops over days and declines within weeks and sometimes months. The diagnosis of Bell’s palsy relies on sign and symptoms as there isn’t any particular test to detect this disease yet. Usually, the patient’s physical condition is closely examined by a doctor. To do this, certain tests such as MRI, X-rays, and blood tests may also be used to obtain more information and to rule out other diseases causing similar symptoms. Once the doctor is certain that signs and symptoms are not caused by other conditions such as head trauma, tumor, bone fracture, stroke, or lyme disease then facial paralysis will be confirmed due to Bell’s palsy. In terms of treatment, usually Bell’s palsy patients can recover in nine months without any treatments. However, to insure proper and complete recovery it is recommended to use medical treatments which include certain medications such as prednisolone which is a corticosteroid that is used to reduce inflammation. Along with prednisolone, antiviral drugs are also used and can be very effective when used together. Eye protection is also recommended for those patients who are unable to close eyes or blink. The tears and moisture or the eyes evaporate making them dry and sensitive. It also makes the eyes prone to infections. Protective measures may include eye drops to lubricate the eye during the day and eye ointment to lubricate the eye at night. If the facial weakness is not recovered completely then the patient is required extended treatment. This can include facial retraining which is a facial physiotherapy series that helps strengthen the facial muscles and enhance their range of movement and co-ordination. In other cases, botulinum toxin injections (Botox) can be injected to control any abnormal muscle movements or to help relax any muscles that have become tight. In rare cases, plastic surgery can also be done. Although it doesn’t alter nerve function it can be used to improve facial appearance. Furthermore, Bell’s palsy can lead to several complications based on the severity of nerve damage. Those patients that cannot recover can have impaired speech, impaired taste sensation, asymmetrical smile, drooling, numb nostril area, dry eye, corneal damage, and abnormal blinking. Other complication can result in hyperacusis that is hearing of sounds louder than the actual, busccinator paralysis in which food gets stuck in the paralyzed cheek, and synkinesis in which voluntary movements are accompanied by involuntary movements. Overall, Bell’s palsy patients recover within weeks to month. In rare cases serious complications may arise. Body of Review The exact cause of Bell’s palsy in unknown. It is thought to be a result of infection or inflammation of the facial nerve. Other risk factors may include: diabetes, lyme disease, HIV, cold, flu, weakened immune system and more. Having family members who have Bell’s palsy can add to your risk as well. A recent study, the aim was to compare genetic and recurrence tendency between facial palsy in MRS, and if Bell’s palsy is genetic (Sun et al., 2015). The most meaningful finding was that Bell’s palsy is rarely recurrent and family members who have had Bell’s palsy may increase the risk of Bell’s palsy but those risks are very minimal. Many other factors can influence to developing Bell’s palsy (Sun et al., 2015). The diagnosis of Bell’s palsy is gradually getting easier. In a recent article measuring of facial movements with Photoshop software during treatment of facial nerve palsy has opened new possibilities for the diagnosis and prognosis of Bell’s palsy. Patients now can be evaluated before and after treatment using the Adobe Photoshop scaling system and facial grading system (FGS) to measure facial movements (Pourmomeny et al., 2011). Photoshop method is defiantly much more efficient and can directly compare key points or landmarks using digital photographs. This method can also depict amplitude of muscle contraction in the impaired and normal sides. The Photoshop method is also very impressive because it can measure each marker individually. Overall, it gives very precise measurements quick and easy without having to do them manually. However, the Photoshop method does not stand alone. There are in fact even more possibilities on diagnosis and management of Bell’s palsy. In another recent study, another approach to diagnose Bell’s palsy was to see if ultrasound can provide a new approach for evaluating patients with Bell’s palsy in comparison to known electrophysiological techniques. Ultrasound pictures of the facial nerve were taken during an experiment of patients with Bell’s palsy before and after treatment. The ultrasound technique was a very successful technique to use for prognosis. It is a very quick, easy, and painless technique to perform which makes this technique even more favorable when examining this neurological disorder (Lo et al., 2010). It was concluded some suggestions and other ways patients can diagnose and manage this condition includes the use of antiviral medication, Botox injections, corticosteroid therapy, physiotherapy, acupuncture, and plastic surgery (Mooney, 2013). Patients are usually prescribed acyclovir or valaciclovir at first to treat facial paralysis. Many agreed treatments are available and emotional care of these patients is also important because facial disability can cause a great deal of stress, anxiety, and patients can suffer a loss of confidence and discomfort as well (Mooney, 2013). Another significant finding in terms or recovery, was an article on phototherapy.
It claimed that in fact phototherapy has had a positive affect with a successful outcome (Marques et al., 2011). A gentle laser light had a positive effected on the nerve regeneration and consequent recovery of normal nerve physiology. The laser light stimulated reinervation of the tissues by either the penetration of the axons or on adjacent Schwann’s cells inducing the compromised tissue to secrete proteins related to nerve growth or the releasing of mediator of nerve growth that will affect non-damage adjacent nerves. These aspects were reflected on the treatment of the patient (Marques et al,
2011).
Fitzgerald, M., et al. “Red/near-infrared irradiation therapy for treatment of central nervous system injuries and disorders.” Rev. Neurosci. 24.2: (2013): 205-26.
Purpose- To identify the functions of the cranial nerve of the peripheral nervous system such as the olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, and the hypoglossal nerves. I will examine these functions with a series of behavior tests on my partner Jazmine Cooley to see if all nerves are functioning properly and if they are not, then this will be considered an identified dysfunction of a cranial nerve which is a diagnosis. Materials and Methods- Gloves Container full of substance Standardized eye chart Tape line
...tive to intrathecal administration of morphin than tactil allodynia. Therefore, examination of both modalities is important when examining the spinal pharmacology of the nerve-injured state
Flaccid dysarthria results from damage to the lower motor neurons (LMN) or the peripheral nervous system (Hageman, 1997). The characteristics of flaccid dysarthria generally reflect damage to cranial nerves with motor speech functions (e.g., cranial nerves IX, X, XI and XII) (Seikel, King & Drumright, 2010). Lower motor neurons connect the central nervous system to the muscle fibers; from the brainstem to the cranial nerves with motor function, or from the anterior horns of grey matter to the spinal nerves (Murdoch, 1998). If there are lesions to spinal nerves and the cranial nerves with motor speech functions, it is indicative of a lower motor neuron lesion and flaccid dysarthria. Damage to lower motor neurons that supply the speech muscles is also known as bulbar palsy (Pena-Brooks & Hedge, 2007). Potential etiologies of flaccid dysarthria include spinal cord injury, cerebrovascular accidents, tumors or traumatic brain injury (Pena-Brooks & Hedge, 2007). Possible congenital etiologies of flaccid dysarthria include Moebius syndrome and cerebral palsy. Flaccid dysarthria can also arise from infections such as polio, herpes zoster, and secondary infections to AIDS (Pena-Brooks & Hedge, 2007). Additionally, demyelinating diseases such as Guilian-Barre syndrome and myotonic muscular dystrophy can also lead to flaccid dysarthria (Pena-Brookes & Hedge, 2007). The lower motor neuron lesion results in loss of voluntary muscle control, and an inability to maintain muscle tone. Fasciculations, or twitching movements, may occur if the cell body is involved in the lesion (Seikel et. al., 2010). The primary speech characteristics of flaccid dysarthria include imprecise consonant production, hypernasal resonance, breathiness, and harsh voice (...
MG patients have only one-third of the normal numbers of acetylcholine receptors which causes weak and easily fatigued muscles. The muscles under voluntary control are affected. The heart muscles, which are under involuntary control, are not affected. In MG generally, the muscles that control the eye and eyelid movement are affected first, causing the eyelids to sag. Some MG patients may develop double or blurred vision. When only the eye muscles are affected, the disease is known as Ocular Myasthenia. Disease symptoms affecting the facial muscles leads to limitations of facial expressions. Victims have difficulty smiling and expressing emotions on their face.
...ith photodynamic therapy. Neoplastic tissues would take up compounds of photosensitizing agents, and the interaction of light with the photosensitizing agent eventually leads to the production of cytotoxic free radicles[secret]. The advantages of this treatment is that multiple lesions could be treated even though that could take more than one treatment. However, the downside to this treatment is that it is limited only to neoplasms that are at superficial level. Patients might also acquire side effects such as having photosensitization for around 4-6 weeks, or causing tissues to undergo necrosis which sloughs off after some time.[secret] The latter effect would induce pain in patients.
described in an essay called “Shaking Palsy” published in 1817 by a London Physician named
The facial nerve fibers originate from the pons, lateral to the abducens nerves (Marieb & Hoehn). Branches enter the temporal bone through the internal acoustic meatus; they run through the inner ear cavity with the bone before they emerge through the stylomastoid foramen (Marieb & Hoehn). The facial nerve is the motor nerve to all of the muscles of expression in the face; it is distributed by multiple branches as it innervates various facial muscles including: the platysma, buccinator, the muscles of the external ear, the digastric, and the stylohyoid (Gray, 1995). Parasympathetic fibers of the facial nerve innervate the the lacrimal glands of the eyes, nasal and palatine glands, and the submandibular and sublingual salivary glands (Marieb & Hoehn).
Many people have heard the term cerebral palsy and may have a personal perception about the appearance and effects of this
Two treatment types are being studied for spinal cord injury: injection of an antagonist of the ATP-sensitive receptor P2X7 and transplantation of human embryonic stem cell derived oligodendrocyte progenitor cells. In the spinal cord, ATP can act as an excitatory neurotransmitter (Domercq et al,. 2009). ATP is released in excess for six hours after the initial damage. Most tissue damage happens after the main injury occurs, so finding a treatment that will slow the secondary injury down is a main interest for clinical treatment studies. Injecting a P2X7 antagonist that is sensitive to ATP into the region of the spinal cord that has been damaged has been found to slow down secondary injury (Peng et al., 2009). Also, demyelination of neurons can be found after spinal cord injury. Transplanting human embryonic stem cell derived oligodendrocyte progenitor cells into the damaged tissue has shown to help with remyelinating the neurons. Th...
The time required for recovery and recuperation in laser treatment is less than that required for surgery.
...rocess and is cost effective for many patients. It has also generated a positive impact on patient’s comfort and convenience. Yet still, the selection of an optimal modality remains amongst the scientific and medical communities. Further research and clinical trials to support these positive effects on wound healing may help generate that consensus and help ES therapy gain full support in the US. In reviewing the above studies the evidence of the numerous beneficial effects ES therapy has are clear, however, the evidence that the lack of consensus on standardization of parameters to devise systematic protocols for its use and the lack of uniformity in reports on ES dosages, application modes and waveforms is also clear. Further research trials are needed in order to prove the effectiveness and benefits of electrical stimulation therapy as it relates to wound healing
Laser therapy has been accepted widely by the general public and the medical professionals for its extensive benefits. This therapy precisely targets the affected area, minimizes the use of general anesthesia, encourages shorter hospital stay and improves the patient outcomes. These benefits have lead to its increased use and importance worldwide.
...t optogenetics has huge potential to help save lives and that it will have a big impact in the near future around the world. Because optogenetics is performed on the brain, one mess up has the potential to change the patient’s life drastically if not done correctly, so its performance on humans will not be soon because of the need for this technique to be perfected. “Neuroscientists are eagerly, but not always successfully, looking for proof that optogenetics—a celebrated technique that uses pulses of visible light to genetically alter brain cells to be excited or silenced—can be as successful in complex and large brains as it has been in rodent models” (“Neuroscience Method” 1). Scientists have yet to uncover the endless possibilities of optogenetics and when they do, it can improve the well-being of humans all over the world and thrive for the generations to come.
Bell’s palsy is also known as facial palsy. It is the paralysis or weakness of muscles in one side of the face caused by several different viruses. In some rare cases it can affect both sides of the face. It has similar symptoms to a stroke but if it just affects the facial muscles it is likely not a stroke. It was first described in 1821 but can be traced back to 5th century BCE (Sajadi, 2011).