Concluded Case

Viral bell's palsy .

A male 45yrs has mild grade fever running nose nausea loose motion 3to5/day off and on Mild cough since last 5to 7days. Cbc urine exam bs blood urea serum creatinine and liver function all are within normal limits. Taken tt for viral fever .responded well with tt. On 5th day devloped inability to open lt eye and tricling of saliva and water from lt side of mouth. Pictures are enclosed below.kindly heighlight over complication and tt plan and ?cause.

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Idiopathic facial paralysis. Sudden weakness in the muscles on one half of the face. Bell's palsy may be a reaction to a viral infection. It rarely occurs more than once. Bell's palsy, also known as acute peripheral facial palsy of unknown cause, can occur at any age. The exact cause is unknown. It's believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. Or it might be a reaction that occurs after a viral infection. Stress weakens the immune system and damages the seventh cranial nerve (or the facial nerve) which causes facial paralysis. The condition causes one side of your face to droop or become stiff. A Bell's Palsy patient will face trouble in smiling or closing the eye on the affected side. The most widely accepted treatment for Bell palsy is corticosteroid therapy. However, the use of steroids is still controversial because most patients recover without treatment. Antiviral agents have also been studied in this setting, as have combinations of the 2 types of drugs.

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Idiopathic facial paralysis. Sudden weakness in the muscles on one half of the face. Bell's palsy may be a reaction to a viral infection. It rarely occurs more than once. Bell's palsy, also known as acute peripheral facial palsy of unknown cause, can occur at any age. The exact cause is unknown. It's believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. Or it might be a reaction that occurs after a viral infection. Stress weakens the immune system and damages the seventh cranial nerve (or the facial nerve) which causes facial paralysis. The condition causes one side of your face to droop or become stiff. A Bell's Palsy patient will face trouble in smiling or closing the eye on the affected side. The most widely accepted treatment for Bell palsy is corticosteroid therapy. However, the use of steroids is still controversial because most patients recover without treatment. Antiviral agents have also been studied in this setting, as have combinations of the 2 types of drugs.

Pt covid 19 report is found to positive.
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BELL'S FACIAL PALSY. R/O CVA : Examine for all the reflexes, muscle power in all four limbs. Advice CT Brain. Rx FOR BELL'S PALSY : 1. ANTIVIRAL (USUALLY HERPES) :- Tab Aciclovir 400 mg 5 hourly for 10 days. 2. ANTI INFLAMMATORY (TO REDUCE OEDEMA AT FACIAL CANAL) :- Tab Prednisolone in tapering doses. 3. TREATING NEUROPATHY :- Inj Neurrobion - 1 amp im weekly × 10 such 4. PPI to get rid of Prednisolone associated gastritis. 5. FACIAL MUSCLE STRENGTHENING :- Physiotherapy. May advice for chewing chewing gums for at least 6 months. 6. COUNSELLING :- Cent percent cure is possible in early presentation and initiation of treatment. In some patients specially when treatment is delayed may have residual paralysis.

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ALTHOUGH... SOME. OF. THE. PICs. ...CREATE CONFUSION. ABOUT. THE. REAL. STATUS....OF. THE. FACIAL. IMPRESSIONS...ABOUT. PARALYSIS.. ..BUT. STILL. PRESUMING. IT. TO. BE .....REAL. HEMI FACIAL. PARALYSIS... .. SUGGESTIVE. OF ... EPSTEIN. - BARR. VIRUS... INDUCED BELL'S. PALSY...

? FACIAL PALSY..LT..SIDED.. ? BELL'S PALSY.. LT ..SIDED..

A case of bell,s palsy

Lt Facial palsy

As per details & images mentioned, patient is case of Bell's palsy causing facialpalsy... as it usually followed damaging VII cranial nerve after viral infection . IV.Steroid for 3-4 days later shift on oral steroid tablet for 5-10 days ,with BSL observation. Tab.Becocnx D3 Eye drop for 3-5 days in affected eye. Facial muscles exercise like blowing of mouth, using balloon blowing, chewing exercise on affected area Will help to recover. Usually symptoms subsides in 5-15 days if regular treatment & mouth exercise

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रोगी अर्दित से पीड़ित है। चिकित्सा संबंधी योग,,,, बृहत वात चिंतामणि रस स्वर्ण युक्त 1 रत्ती एकांग वीर रस 2 रत्ती सत गिलोय 4 रत्ती शहद में मिलाकर सुबह-शाम सेवन कराएं। महारास्नादि क्वाथ 25 ग्राम सुबह-शाम खाने के बाद दें। रोगी को रोजाना गुब्बारे पुलवाएं जिधर से हवा निकल जाता है। निश्चित रूप से लाभ होगा। योग परिक्षित है। पिछले 40 वर्ष से प्रयोग कर रहा हूं।

Viral fever ,with upper respiratory infection with oedmatoues mucous is the pathology. IN such a cases the Eustachian tube and its mucous membrane and stylomastoid foramen will go for edematous allergic reaction .So the 7 the nerve passing out in this canal may go for pressure effect and bells palsy.Steroid therapy is the rule.

Bell's palsy ,LMN 7TH nerve palsy . ,right Antibiotics, oral steroids, neurotrophic vitamins . Eye cover for the night to prevent exposure keratitis . Physiotherapy from 2nd week , IFT, ultrasound, muscle stimulation.

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