BELL’S PALSY

Bell’s PalsyThn.1828 Charles Bell gave the classic

description of what came to be known as Bell's Palsy.

Bell's Palsy is defined as an idiopathic unilateral facial nerve paralysis, usually self-limiting.

anwar wardy w sp.s, dfm

VII PareseFacialis Parese / Facialis Paresis / Facial Palsy.

Idiopathic Facial Palsy Unilateral Peripheral Facial Palsy


PERADANGAN Nn VII (Fasialis) dalam Canalis Nn Fasialis (Radang OMA).

Probably a viral infection of the facial nerve Probably a viral infection of the facial nerve (nervus facialis). Possibly a herpes simplex (nervus facialis). Possibly a herpes simplex type 1 infection.type 1 infection.

The infection leads to inflammation and The infection leads to inflammation and oedema, a swelling of the nerve.oedema, a swelling of the nerve.

Terjadi kelumpuhan otot muka pada sisi yang terkena.

Hilangnya rasa kecap 2/3 lidah depan homolateral; juga kekurangan saliva


Causes


Teknik PemeriksaanMintalah pasien untuk mengangkat

kedua alis matanya, cemberut, menutup mata dengan rapat, memperlihatkan gigi, tersenyum, mengembungkan pipinya.

Kelemahan saraf perifer (Bell’s).(Bell’s).LMN (VII) ; distal setelah keluar dari

canalis facialis, ipsilateral. Lesi serabut intramedullar distal nuclei VII.



1.Nervus facilalis, the 7th cranial nerve, originates in a so-called nucleus area in the brain. Signals from motor centres elsewhere in the brain, to command the voluntary facial motor muscles, are first sent to this nucleus, and then via the nervus facialis to the muscles.

2. The nerve travels through a narrow canal in the skull (the potential point of compression)

3. This is the inner ear canal.4. Here the nerve starts branching out; The nerve reaches

three major areas, 5. Upper facial area - eye (upper eye lid), eyebrow, muscles in

the forehead, wrinkle muscles6. Middle facial area - nostril contraction, lower eyelid, in

particular muscles that lift the corner of the mouth when smiling

7. Lower facial areal - lips, chinBut also other muscles controlling the front of the neck

(8), ear movement (9) and scalp (10).11. The nerve also controls a reflex muscle in the ear (nervus

stapedius) that contracts the auditory canal to protect delicate parts in the inner ear in case of load sounds. Testing this reflex may be part of the diagnosis of Bell's Palsy.




TERIMA KASIH


Kasse et al. (2003) :

1521 patients with Bell’s palsy (Saö Paulo:1986 to 2000)The paralysis degree was classified

according to the House–Brackmann grading scheme which runs from 1-4 weeks:

1 weeks is complete recovery. Follow-up time ranged from 3 weeks to 6

months, and the final degree of the facial palsy was determined at the 6th month.



The previous symptoms presented The previous symptoms presented the following incidences: the following incidences:

1.1.No previous symptoms 26.2%, ear pain No previous symptoms 26.2%, ear pain 23.5%, stress 19%, facial changes in 23.5%, stress 19%, facial changes in sensibility 15.8%, headache 8.9%, sensibility 15.8%, headache 8.9%, aphthous ulcers in the mouth 4.6%, and aphthous ulcers in the mouth 4.6%, and others 1.9%.others 1.9%.

2.2.A statistically significant relationship was A statistically significant relationship was observed between the absence of observed between the absence of symptoms and final degree II–IV. Among symptoms and final degree II–IV. Among the previous symptoms, changes in facial the previous symptoms, changes in facial sensibility were related to final degree I. sensibility were related to final degree I.

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BELL’S PALSY