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z_MS1_Neuro Study > GF10: Neuro Bell's Palsy > Flashcards

GF10: Neuro Bell's Palsy Flashcards

1
Q

What is Bell’s Palsy?

A

A dysfunction of cranial nerve VII that manifests in facial muscle weakness or paralysis on one side of the face

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2
Q

What is the Patho of Bell’s Palsy?

A

Malfunction results from inflammation of CNVII causing compression where it exits the skull to travel to the face

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3
Q

What are some possible causes of Bell’s Palsy?

A
  • Idiopathic
  • Associated w/ viral infections
  • Triggered reactivation of a dormant virus
  • Brain tumors, meningitis, middle ear infection
  • A demyelinating or autoimmune disease
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4
Q

What are some viral infections associated with Bell’s Palsy?

A
  • Cold sores, genital herpes (herpes simplex virus)
  • Chickenpox, shingles (varicella-zoster virus)
  • Mononucleosis (Epstein-Barr virus)
  • Cytomegalovirus (CMV)
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5
Q

What are some triggers that can reactivate a dormant virus and result in Bell’s Palsy?

A
  • Stress
  • Trauma
  • Minor illness
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6
Q

What are some risk factors of Bell’s Palsy?

A
  • Diabetes
  • HTN
  • Obesity
  • Pregnancy
  • Upper Respiratory Infections
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7
Q

How is Bell’s Palsy diagnosed?

A
  • Based on clinical presentations after other possible causes of facial paralysis are ruled out
  • Clinical presentations include unilateral forehead, eyelid and mouth paralysis/weakness
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8
Q

When assessing for Bell’s Palsy, what is indicated if forehead is not affected?

A

it is indicative of stroke, as CNVII includes muscles of forehead

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9
Q

What diagnostic tests are used for Bell’s Palsy?

A
  • MRI, CT
    • To rule out structural studies such as tumor or skull fracture
  • Electromyography
    • Used to confirm nerve damage and determine the extent of severity
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10
Q

What are the s/s of Bell’s Palsy?

A
  • Unilateral paralysis/weakness of the face
  • Drooping eyelid/mouth w/ inability to close eye
  • Drooling
  • Inability to smile symmetrically
  • Decrease in lacrimation to eye (dry eye)
  • Flattening of nasolabial fold
  • Abnormal/distorted sense of taste
  • Facial pain
  • Intolerance to loud noise
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11
Q

How do the s/s of Bell’s Palsy evolve?

A
  • Symptoms develop suddenly, reaching peak severity around 72hrs after onset
  • s/s usually self-resolve without medical attention
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12
Q

What are the nursing interventions for eye care of the Bell’s Palsy pt?

A
  • Eyelid ability to close/blink is impaired
  • Eye at risk for drying and potential injury
  • Must keep eye moist with lubricating eye drops
  • Protect from injury w/ eyepatch, especially at night
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13
Q

What is the percentage ratio of those who recover from Bell’s Palsy to those who have continuing long-term issues?

A
  • 90% (with and without tx) will recover completely
  • 10% of cases that had severe nerve damage may have some symptoms for life
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14
Q

Symptoms tend to improve after a __ - __ weeks and a complete recovery is achieved in about __ months

A
  • 2-5 wks
  • 6 mos
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15
Q

What is the medication tx for Bell’s Palsy?

A
  • Corticosteroids (prednisone), when started early (w/in 3 days), can reduce inflammation and improve recovery
  • Pending cause, antivirals (acyclovir, famciclovir, valacyclovir) or vaccines (zoster’s for shingles) can help resolve the inflammation of CNVII
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16
Q

What are the physical tx may provide relief for the Bell’s Palsy pt?

A
  • Some pts benefit from pt or facial massage
  • Apply warm moist heat, to help circulation, relieve pain/inflammation
17
Q

True or False

Decompression surgery to relieve pressure on nerve is usually recommended

A

False, Decompression surgery to relieve pressure on nerve is rarely needed and not usually recommended

18
Q

Describe CNVII

A
  • One facial nerve for each side of the face
  • Controls muscles of facial expression (including eye blinking and closing)
  • Carries nerve impulses to tear and salivary glands
  • Conveys taste sensations from anterior two-thirds of tongue
19
Q

How is taste affected by CNVII dysfunction?

A

No sweet or sour taste, bitter is back of tongue and not affected

20
Q

What is our general pt education for Bell’s Palsy?

A
  • Eye patch or tape eye closed at night
  • Use artificial tears to prevent dry eyes
  • Wear glasses to prevent injury
  • Chew on unaffected side w/ oral hygiene after every meal
  • Clients can still drive and don’t need walking assist devices as their balance and limbs are NOT affected
21
Q

What are some possible complications that may arise for 10% of Bell’s Palsy pts?

A
  • Chronic loss of taste (ageusia)
  • Chronic facial spasm
  • Corneal infections (from not protecting eyes)
  • Facial pain (rare)

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