What does Benphysio have to say about Bell's Palsy?
What is Bell’s Palsy?
Bell’s palsy adalah satu keadaan neurologi tidak progresif yang dicirikan oleh kehadiran lumpuh tiba-tiba pada saraf kranial ke-7 (saraf muka) di sisi yang sama. Saraf muka bertanggungjawab untuk fungsi deria dan motor, termasuk sensasi rasa di dua pertiga bahagian hadapan lidah dan pergerakan otot muka. Walaupun punca sebenar Bell’s palsy masih tidak diketahui (idiopatik), beberapa jangkitan virus telah dikenal pasti sebagai faktor risiko berpotensi, terutamanya virus herpes simplex, virus varicella-zoster, dan virus Epstein-Barr. Pesakit dengan Bell’s palsy biasanya mengalami kelemahan atau lumpuh muka yang semakin teruk dengan cepat dalam beberapa hari pertama selepas bermula. Berita baiknya, tanda-tanda pemulihan biasanya mula muncul dalam masa kira-kira dua minggu. Rajah di bawah menunjukkan cabang-cabang saraf muka.
We at Benphysio do provide this service in all our outlets in Oval Damansara, Bangsar, Puchong, KL Ampang, Cheras and Giza KD.
Bell’s palsy vs stroke
Etiology:
Bell’s palsy: No exact cause but most likely it is associated with viral infections. Bell’s palsy is only diagnosed when there is not a known cause of the symptoms.
Stroke: A stroke occurs when there is interruption of the blood supply to a particular area of the brain which leads to cell injury and cell death. Mainly 2 types: ischemic and hemorrhagic. Ischemic stroke happens when the brain's blood vessels become blocked or narrowed which results in severely reduced blood flow whereas hemorrhagic stroke occurs when a blood vessel in the brain ruptures and bleeds.
Affected areas and its symptoms:
Bell’s palsy: Primarily affects the facial nerve, resulting in weakness or paralysis to one side of the face. Symptoms are localized to the face, such as inability to wrinkle at the forehead, close the eye, drooping of the mouth, loss of taste, and altered tear and saliva production.
Stroke: Can affect various parts of the body depending on the areas of the brain affected. Symptoms can include hemi-sensory loss and hemi-paresis on one side of the body (face, arm, leg), aphasia, perceptual deficits, loss of balance and coordination, memory deficit, urinary incontinence and others. Most importantly, patients with stroke retain the ability to wrinkle their forehead on the affected side.
Symptoms of Bell’s palsy
Bell’s palsy typically presents with rapid onset facial weakness, usually affecting one side of the face, developing over a few hours and potentially worsening over several days. The extent of facial nerve involvement can vary, leading to a range of symptoms based on whether the nerve is partially or fully affected. Common symptoms include:
· Facial Droop: One side of the face may sag, and only half of the face may move when smiling.
· Forehead Wrinkling and Facial Movements: Inability to wrinkle the forehead, whistle, or blow out the cheek.
· Eye Closure Issues: The inability to close one eye may result in a watery or dry eye.
· Hearing Sensitivity: Loud sounds may be uncomfortable, and normal noises may seem louder than usual due to the dysfunction of a small muscle (stapedius) in the ear.
· Speech Difficulties: Speech may be affected, particularly for words beginning with the letter 'P', due to the impaired function of facial muscles.
· Chewing Difficulties: Chewing food on the affected side can be problematic, with food potentially getting trapped between the gum and cheek. Drinks and saliva may escape from the affected side of the mouth.
· Taste Loss: Loss of taste on the side of the tongue that is affected.
· Pain: Most cases are painless or cause just a mild ache, though some individuals may experience pain near the ear lasting a few days.
Physiotherapist’s Management
1.Facial exercises
Facial rehabilitation helps to strengthen the muscles which are paralyzed and weak. Below are some examples of facial exercises that will be prescribed by physiotherapists.
- Electrical stimulation
Electrical stimulation is used to send electrical muscles to stimulate the weak or paralyzed facial muscles. This needs to be done with a physiotherapist.
- Facial STM
There are many techniques to stimulate the weak or paralyzed facial muscles with manual therapy, for instance effleurage, finger or thumb kneading, hacking, tapping, and stroking. Patients can sometimes perform self-massage at home after being taught by a physiotherapist.
4.Patient education
- Using an eye patch and lubricants to prevent drying of the cornea is crucial.
- Apply moist heat to the paralyzed area to help reduce pain
- Try drinking with straw, eating chewing gum
- Eat on the side of your mouth that feels most comfortable
Again, we at Benphysio do provide this service in all our outlets in Oval Damansara, Bangsar, Puchong, KL Ampang, Cheras and Giza KD. We specialized in hands-on physiotherapy to treat the problem. Feel free to call us to make an appointment to get your problem diagnosed by our physiotherapists and fixed via hands on physiotherapy.
Created by: Jackson (Puchong)
References:
Rajangam, J., Lakshmanan, A. P., Rao, K. U., Jayashree, D., Radhakrishnan, R., Roshitha, B., Sivanandy, P., Sravani, M. J., & Pravalika, K. H. (2024). Bell Palsy: Facts and Current Research Perspectives. CNS & neurological disorders drug targets, 23(2), 203–214. https://doi.org/10.2174/1871527322666230321120618
Spencer, C. R., & Irving, R. M. (2016). Causes and management of facial nerve palsy. British journal of hospital medicine (London, England : 2005), 77(12), 686–691. https://doi.org/10.12968/hmed.2016.77.12.686
Neil S. Norton (2007). Bell's Palsy: The Comprehensive Pharmacology Reference, Elsevier, 2007, Pages 1-4, ISBN 9780080552323, https://doi.org/10.1016/B978-008055232-3.60672-5.
Murthy, J. M., & Saxena, A. B. (2011). Bell's palsy: Treatment guidelines. Annals of Indian Academy of Neurology, 14(Suppl 1), S70–S72. https://doi.org/10.4103/0972-2327.83092
Somasundara, D., & Sullivan, F. (2017). Management of Bell's palsy. Australian prescriber, 40(3), 94–97. https://doi.org/10.18773/austprescr.2017.030
Martineau, S., Rahal, A., Piette, É., Chouinard, A. M., & Marcotte, K. (2021). The Mirror Effect Plus Protocol for acute Bell's palsy: a randomised and longitudinal study on facial rehabilitation. Acta oto-laryngologica, 141(2), 203–208. https://doi.org/10.1080/00016489.2020.1842905
Tuncay, F., Borman, P., Taşer, B., Ünlü, İ., & Samim, E. (2015). Role of electrical stimulation added to conventional therapy in patients with idiopathic facial (Bell) palsy. American journal of physical medicine & rehabilitation, 94(3), 222–228. https://doi.org/10.1097/PHM.0000000000000171
Coulson SE, Fargher KC. Effectiveness of electrical stimulation for rehabilitation of facial nerve paralysis. Phys Ther Rev. 2017;22(3–4):169–176.
Kanika, Sharma, N., Yadav, A., & Kumar, P. (2023). Effectiveness of facial palsy protocol among patient with mucormycosis following COVID-19: A case study. Heliyon, 9(2), e13209. https://doi.org/10.1016/j.heliyon.2023.e13209
Hammell, D. C., Zhang, L. P., Ma, F., Abshire, S. M., McIlwrath, S. L., Stinchcomb, A. L., & Westlund, K. N. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European journal of pain (London, England), 20(6), 936–948. https://doi.org/10.1002/ejp.818
http://www.myhealth.gov.my/en/physiotherapy-management-bells-palsy/
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25 Nov 2024
