Bells Palsy

Persons with Neurological DefectsSpecial NeedsBells PalsyFacial nerve paralysisDamage to the facial nerve may cause imbalance of the face at rest as well as distortedAsymmetrical facial expressions (e.g. smiling, laughing, grimacing, etc.). Facial nerve paralysis

Functionally, facial nerve injury affects chewing, fluid retention while drinking, nasal breathing, corneal exposure, speech patterns, and communication skills. At rest, the loss of facial muscle tone causes downward droopiness of the brow, eyelid, nostril, lip, and cheek on the paralyzed side of the faceSigns and symptomsOnset is abruptParalysis can be partial or complete on affected sideSymptoms can last for several hoursPain in ears can precede palsy by a day or twoSymptoms often noticed upon wakeningThe quicker signs and symptoms progress the more serious the paralysis and weakness

Damage to the facial nerve may cause imbalance of the face at rest as well as distorted, asymmetrical facial expressions (e.g. smiling, laughing, grimacing, etc.). What causes Bell's palsy?The cause of Bell's palsy is not clear. Most cases are thought to be caused by the herpes virus that causes sores The nerve that controls muscles on one side of the face is damaged by inflammation.Many health problems can cause weakness or paralysis of the face. If a specific reason cannot be found for the weakness, the condition is called Bell's palsySymptomsSudden weakness or paralysis on one side of your face that causes it to droop. This is the main symptom. It may make it hard for you to close your eye on that side of your face.Drooling.Eye problems, such as excessive tearing or a dry eye

Symptoms

Loss of ability to taste.Pain in or behind your ear..Numbness in the affected side of your face.Increased sensitivity to soundHow is it TreatedMost people who have Bell's palsy recover completely, without treatment, in 1 to 2 months This is especially true for people who can still partly move their facial muscles A small number of people may have permanent muscle weakness or other problems on the affected side of the face.

Dental Hygiene CareFrequent dental hygiene appointmentsShort appointments, preferably in the morningA relaxed environment to reduce stressSensitivity to hot or cold environment needs to be addressed for the patientIn addition, the patient should have eyewear and airway protectionFrequent dental hygiene appointments will help prevent oral infections and thus prevent exacerbations of the disease process. Short appointments scheduled in the morning may minimize fatigue, and a comfortable, quiet, relaxed environment may reduce stress.10Dental Hygiene Care

Emphasize personal home care on afflicted side due to the oral musculature numbnessEstablishing a brushing patternRemind patient to always rinse with waterUse of an oral irrigator would be helpful

Oral Clinical FindingsOther common effects are dry mouth, glossitis and candidiasisNumbness could lead to oral trauma, ie cheek biting and increased debris on the side of the mouth that is affectedhttp://www.youtube.com/watch?v=wHTPfPcOHyo&feature=related

Amyotrophic Lateral Sclerosis (ALS)

(Lou Gehrig's disease, Motor Neuron Disease)Often referred to as "Lou Gehrig's Disease," is a progressive neurodegenerative disease.The progressive degeneration of the motor neurons in ALS eventually leads to their deathThat affects nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body14When the motor neurons die, the ability of the brain to initiate and control muscle movement is lostWith voluntary muscle action progressively affected, patients in the later stages of the disease may become totally paralyzedIt is estimated that ALS is responsible for nearly two deaths per hundred thousand population annuallyApproximately 5,600 people in the U.S. are diagnosed with ALS each year. ALS is not contagiousALS occurs throughout the world with no racial, ethnic or socioeconomic boundariesThe incidence of ALS is two per 100,000 people, and it is estimated that as many as 30,000 Americans may have the disease at any given time.16Affects of ALSAbout twenty percent of people with ALS live five years or more and up to ten percent will survive more than ten years and five percent will live 20 yearsRiluzole, the first treatment to alter the course of ALS, was approved by the FDA in late 1995Since ALS attacks only motor neurons, the sense of sight, touch, hearing, taste and smell are not affected. For many people, muscles of the eyes and bladder are generally not affectedClinical Care For An ALS PatientBecause hands and feet may be affected first, care should be given as to what devices should be given to the patientFrequent DH appointments are encouragedElectric toothbrushWater pic, and or flosserMorning appointments for the patient to minimize fatigueFrequent dental hygiene visits are encouraged to monitor oral health and hygiene and to reinforce preventive self-care procedures for both client and caregiver.18http://www.youtube.com/watch?v=Dp4q8YNF9o4Seizure DisordersA brief disturbance of cerebral function caused by excessive abnormal neuronal discharge.Seizures are common1% of children younger then 5 years will have at least one seizure, most likely associated with a high feverResult from primary CNS dysfunction or underlying systemic or metabolic disorderSeizures happen during ones lifetime at least a probability of 6% of having one, and a 3% of having more then one. About 1% of children younger then 5 experience at least one caused by a high fever. Seizures result from primary CNS dysfunction or an underlying systemic or metabolic disorder21CharacteristicsInclude: a loss or altered state of consciousness, Abnormal or cessation of motor activitiesAbnormal sensory perceptionsAnd / or loss of bowel and bladder control 22EpilepsyA seizure disorder which excessive abnormal neuronal discharges from cerebral function disturbances are recurrentCauses of only of both childhood- onset and adult-onset have been foundCharacteristicsTonic-Clonic seizures ( grand mal)Several phases1st phase- vague prodromal symptoms (aura)Brief Bilateral muscle contractionsTonic phaseClonic phase

Many types of seizures, there are 3 common ones for discussion. Tonic-clonic seizure- Prodomal symptoms can occur several hours to several days before the convulsion. A series of brief, bilateral muscle contractions may precede the tonic phase. Tonic (stiffening)contractions begin in the trunk and progress, including contraction of abdominal muscles, producing forced expiration across the sposmodic glosttis and causing the characteristic vocalization. The clonic phase 24http://www.youtube.com/watch?v=02YpZ6sBSHk