,Bell palsy,-Mark,Bell palsy,Which side of the face have problem?,Idiopathic facial palsy,Bell palsy,You wake up one morning, and your face feels stiff，when you look in a mirror, half your face appears to droop. You can only manage half a smile, your eye is dripping tears and doesnt want to close. What in the world is going on?,Bell palsy,No silly its Bell Palsy,Scottish anatomist, surgeon, and physiologist, born November 1774; died 28th April, 1842.,Who is Bell?Charles Bell Well known for his studies on the nervous system and the brain. In the 19th century he discovered that lesions of the 7th cranial nerve causes facial paralysis.,Bell palsy,What nerve was that again?The 7th cranial nerve is paired with the structure that travels through a narrow, bony canal (called the Fallopian canal) in the skull beneath the ear,Bell palsy,The nerve is mostly encased in this bony shell.,Bell palsy,Facial Nerve,Each nerve controls: Eye blinking and closing Facial expressions Smiling and frowning Tear glands(腺体) Taste sensations,Function,Bell palsy,Varies from person to person Comes on suddenly Mild to total paralysis Weakness, twitching (抽搐) on one ofboth sides of the face Facial and eyelid droop Drooling Dryness of eye or mouth Impairment of taste Excessive tearing of eye,Symptom 1/2,Bell palsy,Pain in behind the ear Ringing in one or both ears Impaired speech Difficulty eating and drinking,Symptom 2/2,Bell palsy,What Causes this?,It occurs when the facial nerve is swollen, inflamed, or compressed,Pathogenesis,Bell palsy,So what causes the damage?Mostly unknown May be caused by a viral infection,Pathogenesis,Bell palsy,Diagnosed,There are no special lab tests to confirm diagnosis. Electromyography Confirm presence of damage and determine severity. MRI and CT Causes of pressure on nerve.,Diagnosis,Bell palsy,Treatment,No real TreatmentSymptoms usually subside Anti-inflammatory and antiviral Prednisone（强的松） and acyclovir（阿昔洛韦）Increases the chance of recovery. Acupuncture and surgery for long term paralysis,Treatment,Bell palsy,Treatment Cont.,Hard to close eyeUse eye patchEye dropsTape eye shut when sleeping,Bell palsy,When does it go away?,Outcome is good! Total recovery depends on amount of damage to nerve Improvement is gradual Usually start to get better after 2 weeks of onset and most recover completely within 3 to 6 months. In a few cases, the symptoms may never completely disappear.In rare cases, the disorder may recur, either on the same or the opposite side of the face.,Prognosis,Thank you!,