BELLS PALSY

BRIEF DESCRIPTION SIGNS AND SYMPTOMS DIAGNOSTIC EXAM NURSING INTERVENTION

INDEPENDENT DEPENDENT COLLABORATIVE
(Facial paralysis) is
caused by unilateral
inflammation of the 7
th

cranial nerve, which
results in weakness or
paralysis of the facial
muscles on the affected
side.

Although the cause is
unknown, theories about
causes include vascular
ischemia, viral disease
(Herpes simplex, Herpes
zoster), autoimmune
disease or a combination
of all these factors.

Most adults with Bells
palsy are younger than
45 years old of age
(Carlson & Pfadt, 2005)

May be a type of
pressure paralysis.




The inflamed, edematous
nerve becomes
compressed to the point of
damage, or its blood
supply is occluded
(Ischemic necrosis of the
nerve)

Face is distorted from
paralysis of facial muscles

Increase lacrimation
(Tearing)

Painful sensations in the
face, behind the ear and
in the eye

Patient may experiences
speech difficulties

Maybe unable to eat on
the affected side because
of weakness or paralysis
of the facial muscles.



No specific test for Bells
palsy. Your doctor will look
at your face and ask to
move your facial muscles
by closing your eyes,
lifting your brow, showing
your teeth and frowning

Electromyography
(EMG)

Confirm the presence of
nerve damage and
determine its severity

Measure the electrical
activity of a muscle in
response to stimulation
and the nature and speed
of the conduction of
electrical impulses along a
nerve


Protection of the eye from
injury. (Use a protective shield
at night)

Moisturizing eye drops during
the day and eye ointment at
bedtime may help prevent
injury. (Carlson & Pfadt, 2005)

Wrap-around sunglasses or
goggles may be worn during
the day to decrease normal
evaporation of the eye.

If patient can tolerate touching
the face, the nurse can
suggest massaging the face
several times daily, using a
gently upward motion, to
maintain muscle tone.

Facial exercise, such as
wrinkling the forehead, blowing
out the checks and whistling.
May be performed with the aid
of mirror to prevent muscle
atrophy.

Exposure of the face to cold
and drafts is avoided.

Heat may be applied to the
involved side of the face to
promote comfort and blood
flow through the muscles.


Corticosteroid
treatment
(Prednisone)
To reduce
inflammation and
edema; this redness
vascular
compression and
permits restoration
of the blood
circulation to the
nerve.

Early administration
of this drug appears
to diminish the
severity of the
disease, relieve pain
and minimize or
prevent denervation.
(Carlson & Pfadt,
2005).

Analgesics agent
To control facial pain



Electrical
stimulation may be
applied to the face
to prevent muscle
atrophy.

Surgical
exploration of the
facial nerve may
be indicated if a
tumor is
suspected, for
surgical
decompression of
the facial nerve or
for surgical
treatment of
paralyzed face.