MEDICAL REHABILITATION FOR RIGHT BELL’S PALSY WITH DIABETES MELLITUS TYPE 2 AND MIGRAINE

Abstract

Bell palsy (BP) is the most common peripheral paralysis of the seventh cranial nerve with an onset that is rapid and unilateral. Bell’s palsy (BP) accounts for almost 75% of all cases of acute facial palsy (FP), the incidence varying in the different countries around the world.¹ The annual incidence has been reported to range between 11 and 40 or 8 and 240 cases per 100,000 subjects. The age peak incidence occurs between 15 and 45 years. Females and males are equally affected.²  The diagnosis is one of exclusion and most often made on physical exam. BP is by definition idiopathic in nature. The aetiology of BP is still unclear: viral infections, vascular disease, hypertension and diabetes have been indicated as possible causal agents.³ Treatment of Bell’s palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. ^4,5  Prognosis of Bell’s palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae. The most important prognostic factors for an unsatisfactory prognosis are: complete palsy, absence of recovery in the first three weeks and age over 60 years.