BELL'S PALSY

Bell's Palsy - facial paralysis without evidence of other disease or injury.

Paralysis occurs suddenly or gradually over a period of 24 to 48 hours.
The etiology is uncertain, but may be due to a virus. Inability to close
the eyelids may be partial or complete.

Dangers - lack of blinking leads to corneal dryness (exposure), potential
corneal ulceration with secondary infection, hypopyon or endophthalmitis.
Other symptoms:
(1) epiphora - excess tears from corneal irritation and weakness of lacrimal
pump.
(2) discomfort to pain
(3) difficulty to mastication - food collects on that side of mouth.

Treatment - spontaneous recovery is usual, taking a few weeks to months
but some residual weakness or muscle twitching is common.

* protect the cornea - artificial tears to wet the cornea.
* glasses with side shield, swimming goggles at night.
* strap eyelids together, especially for sleep.
* physiotherapy - muscle stimulation
* forced blinking - if Bell's phenomenon present - elevates the eye under
the upper eyelid and moistens the cornea.
* tarsorrhaphy - medial or lateral.

Other Causes of facial palsy:
* traumatic
* inflammatory
* neoplastic
* nerve pressure