Name
PREGNANCY
DESCRIPTION
DETAIL
CAUSES : * IDEOPATHIC * TUMORS THAT INVADE TEMPORAL BONE LIKE CAROTID BODY TUMOR, CHOLESTEATOMA & DERMOID * RAMSAY HUNT SYNDROME * ACOUSTIC NEUROMA * PONTINE INFARCTS, TUMORS & DEMYELINATING LESIONS OF MULTIPLE SCLEROSIS * GUILLAIN BARRE SYNDROME * UVEOPAROTID FEVER ( HEERFORDT SYNDROME ) - A FORM OF SARCOIDOSIS * LYME DISEASE * MELKERSSON - ROSENTHAL SYNDROME * LEPROSY * DIABETES MALLITUSOTHER TESTS : * LYME TITER
TYPENOTES
GENERAL MEASURES: • Close and patch ipsilateral eye • Methylcellulose ophthalmic drops SURGICAL MEASURES: Total failure of recovery can be treated by anastomosing the dental VII cranial nerve to the proximal end of another cranial nerve DRUG(S) OF CHOICE: • Corticosteroids: Prednisone 80 mg po qd for three days, then 60 mg po qd for three days, then 40 mg po qd for three days, then 20 mg po qd for three days, then discontinue use. Course of treatment to begin immediately after onset of Bell palsy. There is little benefiT in starting steroids after four days. Use of corticosteroids is controversial. • Antiviral agents with activity against herpes group of viruses in Ramsay Hunt syndrome and idiopathic Bell palsy PATIENT MONITORING: • Recheck monthly for six to twelve months • Look for evidence of corneal abrasions. Expect early recovery. POSSIBLE COMPLICATIONS: • Unmasking of subclinical infection (such as tuberculosis) by steroid usage • Steroid-induced psychological disturbances • Steroid-induced avascular necrosis of hips, knees and/or shoulders • Corneal abrasion and ulceration EXPECTED COURSE/PROGNOSIS: • Complete, partial or no recovery of function. Patients with partial denervation typically fully recover. Patients with total denervation usually partially recover, but may exhibit aberrant regeneration (e.g., crocodile tears) or hemifacial spasm as long term complications. • May recur on the same or opposite side
RELATED DISEASE
Not Available Disease
Disease
Remarks
BELL’S PALSY
ACYCLOVIR SHOULD BE AVOIDED BUT CORTICOSTEROIDS CAN BE GIVEN
DISEASE
INVESTIGATION
BLOOD SUGAR ( FASTING ), X-RAY CHEST P.A. VIEW( NORMAL ), BLOOD SUGAR ( AFTER MEALS ), COMPLETE BLOOD COUNT, MRI
[BELL’S PALSY]