What is Bell's Palsy?

• Bell’s palsy is a disease of the 7th cranial nerve (facial nerve) that produces unilateral facial weakness or paralysis.
• Bell’s palsy is named after Scottishanatomist Charles Bell who first described it.

CLINICAL MANIFESTATIONS

Remember BELLS Palsy!

Blink Reflex is not normal

Eye rolls up/ ear ache

Lower lip and eyelid corners

Loss taste and brow twitching

Sudden attack (hours to days )

Paralysis (Unilateral facial nerve VII paralysis)

NURSING INTERVENTIONS

Teaching Eye Care

• Cover the eye with a protective shield at night.
• Apply eye ointment to keep eyelids closed during sleep.
• Close the paralyzed eyelid manually before going to sleep.
• Wear wrap-around sunglasses or goggles to decrease normal evaporation from the eye.

Teaching About Maintaining Muscle Tone

• Show client how to perform facial massage with gentle upward motion several times daily when the client can tolerate the massage.
• Instruct the client to avoid exposing the face to cold and drafts.
• Demonstrate facial exercises,such as wrinkling the forehead, blowing out the cheeks, and whistling, in an effort to prevent muscle atrophy.

Diet & Nutrition

• Instruct the client to chew on the unaffected side of his mouth.
• Provide soft and nutritionally balanced diet. Eliminate hot fluids and foods.
• Give frequent mouth care, being particularly careful to remove residues of food that collects between the cheeks and gums.

MEDICAL MANAGEMENT

• Additional modalities may include electrical stimulation applied to the face to prevent muscle atrophy, or surgical exploration of the facial nerve.
• Surgery may be performed if a tumor is suspected, for surgical decompression of the facial nerve, and for surgical rehabilitation of a paralyzed face.
• Facial pain is controlled with analgesic agents or heat applied to the involved side of the face.
• Corticosteroid therapy (prednisone) may be initiated to reduce inflammation and edema, which reduces vascular compression and permits restoration of blood circulation to the nerve.
• Early administration of corticosteroids appears to diminish severity, relieve pain, and minimize denervation.
• Facial pain is controlled with analgesic agents or heat applied to the involved side of the face.