Nk Day 1. Facial Palsy
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Transcript of Nk Day 1. Facial Palsy
FACIAL PALSY
PERIPHERAL FACIAL PALSY
the most common cranial neuropathy and may originate from various kinds of damage to the seventh nerve
The facial nerve plays a crucial role in emotional expression
Bells palsy
an abrupt onset of unilateral weakness or paralysis of the face due to acute
peripheral facial nerve dysfunction, with no readily identifiable cause, and with some
recovery of function within 6 months
Axelsson S, 2013
Epidemiology
70% of all cases of peripheral facial palsy
the annual incidence is about 30/100 000 population
a peak incidence between the second and fourth decades of life
no difference in gender
No difference side of the face,
and no seasonal clustering
Axelsson S, 2013
Etiology
have not yet been clarified despite extensive research.
Immunological reactions, viral infections, ischaemia and genetic theories have been postulated
So far the aetiology of Bells palsy is still unclear.
Axelsson S, 2013
Clinical Presentation
weakness or complete paralysis of all the muscles on one side of the face.
The facial creases and nasolabial fold disappear, the forehead unfurrows, and the corner of the mouth droops.
The eyelids will not close and the lower lid sags;
on attempted closure, the eye rolls upward (Bells phenomenon).
Tiemstra, Khatkhate, 2007
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Eye irritation often results from lack of lubrication and constant exposure. Tear production decreases;
Food and saliva can pool in the affected side of the mouth and may spill out from the corner.
feeling of numbness from the paralysis, but facial sensation is preserved
Tiemstra, Khatkhate, 2007
Diagnosis
The first step in diagnosis is to determine whether facial weakness is due to a problem in the central nervous system or one in the peripheral nervous system.
This is done rapidly with observation and a few questions
Grading
It is fundamental to have a reliable and valid method of evaluating facial palsy and be able to assess the course of recovery and the effect of treatment over time.
The House-Brackmann scale (HBS) is
the most commonly used grading system and has six grades, where I = normal function and VI = complete paralysis
Grading
Outcomes
Prognostic factors include:
- Age (With increasing age, successful recovery begins to decline)
- severity (HBS)
- time to start of recovery
- time to start treatment
- presence pain on day 11-17 after onset of palsy negatif prognostic factor
MATUR SUKSMA
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