The findings reported in a series of works related to the nature of Bell’s palsy suggest that immune alterations play an important role in the etiopathogenesis of Bell’s palsy . Additional studies were identified from cited references. It is usually unilateral, rarely bilateral and developed over night. Facial nerves pass through the base of the skull connecting the brain to muscles of facial expression. Particularly in palsies grade 4 and above the eye is over exposed and can become dry leading to corneal scarring. If you are not treated immediately, you have a 20% chance of having one side of your face paralyzed forever. There was no similar sensation or weakness in the limbs.
Prior to the first consultation, she was treated with corticosteroid and electro-acupuncture for one and a half years, with incomplete recovery. Pulse and blood pressure measurements were within the normal range for his age. When a favorable opportunity presents itself they “creep” out of hiding and cause disease. There was no cervical lymphadenopathy. Peak incidence occurs in the fifth decade of life and the syndrome is more common in patients with diabetes and in pregnant women . Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. An intranasal inactivated influenza vaccine that included Escherichia coli heat-labile toxin as a mucosal adjuvant was shown to be strongly associated with Bell’s palsy among persons aged 18 years or more. Another study based on the Vaccine Adverse Event Reporting System indicated a potential signal for Bell’s palsy following immunization with intramuscular inactivated influenza vaccine. That study included only 5 cases younger than 18 years of age.
The condition is named for Sir Charles Bell, a Scottish surgeon who studied the nerve and its innervation of the facial muscles 200 years ago. A clinical diagnosis of Bell’s palsy was made. 3). He was referred to the physiotherapist. He was prescribed with prednisolone 60mg (calculated according to 1mg/kg) for six days which was supposed to be taken in equally divided dosage of 30 mg twice in a day. A case study is presented to illustrate the findings in this interesting disease. He was followed up regularly in the outpatient clinic for six months.
He recovered completely without any residual weakness (Fig 1c). It is important to identify exactly what is pressing on or irritating the facial nerve, because different problems require different solutions. With the Western Medicine approach of drug treatment, most patients begin to get significantly better within 3-4 weeks, and about 80 percent recover completely within 3 months. With the newly invented technique of PCR, researchers in the 90’s reported case-studies showing the detection of HSV-1 DNA in the geniculate ganglions of individual patients with Bell’s Palsy, helping to firm up HSV-1’s role. The causes of Bell’s palsy remains unclear, although blood vessel involvement, infections, genetic, and immunologic causes have all been considered. Although when patient was asked to smile his lip was deviated on unaffected side and while opening his mouth was deviated on unaffected side (Fig 1e). Even on asking to raise his eyelids, he was not able raise left eyelid (Fig 1f).
Beal M, Hauser SL. To our knowledge, no population-based epidemiologic study of the association between immunization and Bell’s palsy has been conducted exclusively among children. Also, the wavelength (890 nm) and energy level lie between that of low level infrared laser reported to be effective in the treatment of Bell’s palsy (Table 1).25,26 At present, there are no case reports of the use of MIRE for patients with Bell’s palsy. Heart: Denies murmur, chest pain or swollen extremities. The cell monolayers were observed for cytopathic effects (CPE) for 4 wk. Aseptic meningitis associated with genital HSV lesions appears to be a benign disease in immunocompetent persons, with full recovery expected. Learn about your health condition and how it may be treated.
The patient had been seen regularly by the pediatric dentist for three months for preventive and restorative care and space maintenance. The intraoral examination revealed no etiology for facial nerve paralysis. Despite their importance to this disease, secondary outcome measures such as facial pain or disfigurement were not consistently reported by investigators and were thus not analysed in this meta-analysis. The patient was under symptomatic treatment. In addition, around 6% of individual’s with Bell’s palsy exhibit crocodile tear syndrome on recovery, where they will shed tears while eating. The histopathology of the facial nerve one week after the onset of Bell’s palsy is also has been reported which reported that the entire nerve was infiltrated by inflammatory cells. Myelin breakdown, axonal changes and edema were also reported suggesting viral neuritis.27 On opening the sheath of the nerve, which is found to consist of several layers, the outer layer being thick and the inner layers being very thin indeed, the nerve trunk when eventually exposed appears to be unduly constricted at the level of the stylomastoid foramen.
 Other studies, including systematic review, have shown that that there is insufficient evidence to recommend an antiviral agent in addition to prednisolone in the treatment of Bell’s palsy. Food tended to be lodged in the left cheek. Clinical evaluation for both the severity of paralysis and the presence of complication is the first step before the start of treatment or rehabilitation. Closely related to oral herpes simplex is HHV-2, which is commonly referred to as herpes simplex type 2 or “genital herpes”. Bell’s palsy is a self-limiting condition with a favorable prognosis. Although the etiology of BP is unknown there are strong indications of a viral origin which triggers a neuropathy leading to facial nerve compression and paralysis in the facial canal proximal to the stylomastoid foramen. The most important thing the dentist can do is make a prompt and appropriate referral because early detection of intracranial pathology may improve the prognosis especially in case of children.
1.Dr.Shalini Gupta, Associate Professor, 2.Dr.Kavita Nitish Garg, Senior Resident, Department of Oral Pathology, 3.Dr.Anurag Tripathi, Assistant Professor, Department of Oral Medicine, CSMMU (KGMU), Lucknow, 4.Dr.OP Gupta, Assistant Professor, Department of Surgery, Career Institute of Medical Sciences, Lucknow, UP, India. Massage: Facial massage may help prevent permanent problems with paralyzed muscles before recovery takes place. Khine H, Mayers M, Avner JR, Fox A, Herold B, Goldman DL: Association between herpes simplex virus-1 infection and idiopathic unilateral facial paralysis in children and adolescents. Pediatr Infect Dis J 2008;27:468-69. 11. Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N: Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle. Ann Intern Med 1996 124:27-30.
12. Mattox DE. The list of other possible sources of irritation to the facial nerve is long, and an accurate diagnosis must rule these out. 1. Otolaryngology Head and Neck Surgery. 3rd Ed. St.
Louis, MO: Mosby-Year Book; 1998. p 2767-84.