FACIAL (BELL'S) PALSY

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WHAT IS BELLS PALSY?

Bell’s Palsy is the most common cause of facial paralysis. It is thought to be caused by an inflammatory reaction of the facial nerve to in the most cases the Herpes Virus. The nerve becomes damaged and is unable to transmit nerve impulses to the muscles of the face on one side. Facial paralysis can come on very suddenly ie overnight and can therefore be very traumatic for the patient.

WHAT DO WE TREAT?

Typical Symptoms include:

  • Facial droop on one side
  • Excessive tearing (“crocodile tears”)
  • Ptosis (drooping of the eyelid)
  • Dry eye
  • Altered taste
  • Difficulty chewing, sucking or blowing
  • Slurred speech
  • Altered skin sensation
  • Synkinesis (unable to isolate movement of face)
  • Weakness of facial expression (eg. Close eye, frown, raise eyelids, pout, smile, blow, suck etc)

WHAT TO EXPECT

MEDICATION

Oral steroids are recommended (usually within 72 hours) to reduce nerve swelling. Anti-viral medication is also used however the benefits remain controversial.

PHYSIOTHERAPY

It is advisable to consult a Chartered Physiotherapist who specialises in facial rehabilitation promptly. An accurate assessment with objective markers taken during the initial consultation is critical to planning an appropriate treatment programme for the best result. Management is customised to the nature, severity and distribution of symptoms and specific to the patients treatment response and rate of recovery.

TREATMENT ELEMENTS INCLUDE

We use a range of advanced skills including:

  • Soft tissue techniques
  • Sensory stimulation
  • Active Facial muscle exercise programme
  • Eye hygiene
  • Biofeedback
  • Electrical muscle stimulation.

Repeat testing of the objective markers offers feedback on the recovery index and progress of the nerve.

PROGNOSIS

The prognosis is generally very good but the extent of nerve damage determines the extent of recovery. Most patients with Bell’s Palsy start to regain normal function within 2-6 weeks and a complete recovery has occurred in two thirds of patient’s at 12 months. Unfortunately in some cases weakness persists and facial expression is compromised. Physiotherapy intervention can specifically address this distressing condition.

The outcome of Bell’s Palsy is largely dependent on getting the correct medication within 72 hours. The largest scale recent study of Bell’s Palsy revealed only 57% of untreated patients achieved full recovery at 12 months and 72% of steroid treated patients achieved full recovery at 12 months. For those that did not recover fully they can be left with an embarrassing longterm chronic disability.

At Baily Point Physiotherapy clinic we provide assessment, treatment and monitoring of recovery which optimises the patient’s recovery.

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