特发性面神经麻痹Bellpalsy

,Bell palsy,-Mark,Bell palsy,Which side of the face have problem?,Idiopathic facial palsy,Bell palsy,You wake up one morning, and your face feels stiff，when you look in a mirror, half your face appears to droop. You can only manage half a smile, your eye is dripping tears and doesnt want to close. What in the world is going on?,Bell palsy,No silly its Bell Palsy,Scottish anatomist, surgeon, and physiologist, born November 1774; died 28th April, 1842.,Who is Bell?Charles BellWell known for his studies on the nervous system and the brain.In the 19th century he discovered that lesions of the 7th cranial nerve causes facial paralysis.,Bell palsy,What nerve was that again?The 7th cranial nerve is paired with the structure that travels through a narrow, bony canal (called the Fallopian canal) in the skullbeneath the ear,Bell palsy,The nerve is mostly encased in this bony shell.,Bell palsy,Facial Nerve,Each nerve controls:Eye blinking and closingFacial expressionsSmiling and frowningTear glands(腺体)Taste sensations,Function,Bell palsy,Varies from person to personComes on suddenlyMild to total paralysisWeakness, twitching (抽搐) on one of both sides of the faceFacial and eyelid droopDroolingDryness of eye or mouthImpairment of tasteExcessive tearing of eye,Symptom 1/2,Bell palsy,Pain in behind the earRinging in one or both earsImpaired speechDifficulty eating and drinking,Symptom 2/2,Bell palsy,What Causes this?,It occurs when the facial nerve is swollen, inflamed, or compressed,Pathogenesis,Bell palsy,So what causes the damage?Mostly unknownMay be caused by a viral infection,Pathogenesis,Bell palsy,Diagnosed,There are no special lab tests to confirm diagnosis.Electromyography Confirm presence of damage and determine severity.MRI and CT Causes of pressure on nerve.,Diagnosis,Bell palsy,Treatment,No real Treatment Symptoms usually subside Anti-inflammatory and antiviral Prednisone（强的松） and acyclovir（阿昔洛韦） Increases the chance of recovery.Acupuncture and surgery for long term paralysis,Treatment,Bell palsy,Treatment Cont.,Hard to close eye Use eye patch Eye drops Tape eye shut when sleeping,Bell palsy,When does it go away?,Outcome is good!Total recovery depends on amount of damage to nerve Improvement is gradualUsually start to get better after 2 weeks of onset and most recover completely within 3 to 6 months.In a few cases, the symptoms may never completely