Stjernquist-Desatnik A, The physical examination should include careful inspection of the ear canal, tympanic membrane, and oropharynx, as well as evaluation of peripheral nerve function in the extremities and palpation of the parotid gland. A test called electromyography (EMG, which uses very thin wire electrodes that are inserted into a muscle to assess changes in electrical activity that occur during movement and when the muscle is at rest) can confirm the presence of nerve damage and determine the severity and the extent of nerve involvement. In some mild cases where recovery is rapid, there is damage only to the myelin sheath (the fatty covering that acts as insulation of nerve fibers).Several other conditions can also cause facial paralysis, for example, brain tumor, stroke, Bell’s palsy affects about 40,000 people in the United States every year. Laboratory evaluation, when indicated by history or risk factors, may include testing for diabetes mellitus and Lyme disease. Bopp M, Linder T, Balzanelli C.
http://www.aan.com/professionals/practice/pdfs/gl0064.pdfGantz BJ, 1 Idiopathic Bell palsy is a common cause, but other reasons—such as Lyme disease, Guillain-Barré syndrome, neurosarcoidosis, meningitis, leukemia, viral infections, syphilis, and basilar skull fractures—must be considered and ruled out by diagnostic testing or clinical presentation. There's no one-size-fits-all treatment for Bell's palsy, but your doctor may suggest medications or physical therapy to help speed your recovery. Patients with corneal abrasions should be referred to an ophthalmologist.Patients with Bell's palsy typically complain of weakness or complete paralysis of all the muscles on one side of the face. Chen RT, The Copenhagen Facial Nerve Study evaluated 2,570 persons with untreated facial nerve palsy, including 1,701 with idiopathic (Bell's) palsy and 869 with palsy from other causes; 70 percent had complete paralysis. Left untreated, 85 percent of patients will show at least partial recovery within three weeks of onset.Bell's palsy is believed to be caused by inflammation of the facial nerve at the geniculate ganglion, which leads to compression and possible ischemia and demyelination.
Pool V, Medical College in Bombay, India. Either acyclovir 400 mg can be given five times per day for seven days or valacyclovir 1 g can be given three times per day for seven days. A potential signal of Bell's palsy after parenteral inactivated influenza vaccines: reports to the Vaccine Adverse Event Reporting System (VAERS) —United States, 1991–2001. In some cases, residual muscle weakness lasts longer or may be permanent. Holland NJ, Symptoms appear suddenly over a 48 - 72-hour period and generally start to improve with or without treatment after a few weeks, with recovery of some or all facial function within six months. Copyright © 2007 by the American Academy of Family Physicians.This page will be removed from your Favorites Links. Approximately 70 to 80 percent of patients will recover spontaneously; however, treatment with a seven-day course of acyclovir or valacyclovir and a tapering course of prednisone, initiated within three days of the onset of symptoms, is recommended to reduce the time to full recovery and increase the likelihood of complete recuperation. Impaired immunity from stress, sleep deprivation, physical trauma, minor illness or autoimmune syndromes are suggested as the most likely triggers.
Wise RP,
Dunn L.
Medications.
Bell's palsy can interrupt the eyelid's natural blinking ability, leaving the eye exposed to irritation and drying. However, because diabetes mellitus is present in more than 10 percent of patients with Bell's palsy, fasting glucose or A1C testing may be performed in patients with additional risk factors (e.g., family history, obesity, older than 30 years).Oral corticosteroids have traditionally been prescribed to reduce facial nerve inflammation in patients with Bell's palsy.
Salinas RA, Your brother is probably suffering from the rare kind of Bell's palsy syndrome, bilateral Bell's palsy. An understanding of how to regenerate peripheral nerves may lead to ways to prevent nerve damage and injuries from occurring.