MEDICAL REHABILITATION IN PATIENT WITH LEFT BELL’S PALSY
Abstract
Bell’s palsy is a complex neuromuscular facial disorder of unknown etiology commonly affecting the motor neurones of facial muscles receiving their neurological innervations from the seventh cranial nerve (the facial nerve).1 Bell's palsy is named after Sir Charles Bell (1774–1842), who first described the syndrome along with the anatomy and function of the facial nerve.2 The facial nerve not only carries motor fibers including fibers to the stapedius muscle but also supplies autonomic innervations of the lacrimal gland, submandibular gland, sensation to part of the ear, and taste to the anterior two thirds of the tongue via the chorda tympani.3 Bell’s palsy accounts for almost three quarters of peripheral facial palsies and the annual incidence is about 15-30 patients per 100.000 annually.The sexes are affected equally. The median age at onset is 40 years, but the disease may occur at any age. The right and left sides of the face are involved with equal frequency.4,5Treatment of Bell’s palsy varies, and no clear consensus exists. The aims of treatment in the acute phase of Bell's palsy include strategies to speed recovery and to prevent corneal complications. Most physicians prescribe corticosteroids as a primary treatment due to its potential to reduce swelling and inflammation. The addition of antiviral treatment (AVT) such as Acyclovir or Valacyclovir is aimed at eradication of HSV infection.6,7 The treatments at Medical Rehabilitation include facial exercise or facial neuromuscular re-education, electrostimulation, infrared rays, and acupuncture, as well as the need for eye-protective and further assessed with electroneurography or electromyography in the presence of complete facial paralysis.
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