Bell’s Palsy

Thn.1828 Charles Bell gave the classic description

of what came to be known as Bell's Palsy.
Bell's Palsy is defined as an idiopathic unilateral
facial nerve paralysis, usually self-limiting.

anwar wardy w sp.s, dfm

VII Parese
Facialis Parese / Facialis
Paresis / Facial Palsy.
Idiopathic Facial Palsy
Unilateral Peripheral Facial
Palsy

anwar wardy w sp.s, dfm

 Causes
PERADANGAN Nn VII (Fasialis) dalam Canalis Nn
Fasialis (Radang OMA).
Probably a viral infection of the facial nerve (nervus
facialis). Possibly a herpes simplex type 1 infection.
The infection leads to inflammation and oedema, a
swelling of the nerve.
Terjadi kelumpuhan otot muka pada sisi yang
terkena.
Hilangnya rasa kecap 2/3 lidah depan homolateral;
juga kekurangan saliva

anwar wardy w sp.s, dfm

anwar wardy w sp.s, dfm
Teknik Pemeriksaan
Mintalah pasien untuk mengangkat kedua alis
matanya, cemberut, menutup mata dengan rapat,
memperlihatkan gigi, tersenyum,
mengembungkan pipinya.
Kelemahan saraf perifer (Bell’s).
LMN (VII) ; distal setelah keluar dari canalis
facialis, ipsilateral. Lesi serabut intramedullar
distal nuclei VII.

anwar wardy w sp.s, dfm

anwar wardy w sp.s, dfm
 1.Nervus facilalis, the 7th cranial nerve, originates in a so-called nucleus
area in the brain. Signals from motor centres elsewhere in the brain, to
command the voluntary facial motor muscles, are first sent to this
nucleus, and then via the nervus facialis to the muscles.
2. The nerve travels through a narrow canal in the skull (the potential
point of compression)
3. This is the inner ear canal.
4. Here the nerve starts branching out; The nerve reaches three major
areas,
5. Upper facial area - eye (upper eye lid), eyebrow, muscles in the
forehead, wrinkle muscles
6. Middle facial area - nostril contraction, lower eyelid, in particular
muscles that lift the corner of the mouth when smiling
7. Lower facial areal - lips, chin
But also other muscles controlling the front of the neck
(8), ear movement (9) and scalp (10).
11. The nerve also controls a reflex muscle in the ear (nervus stapedius)
that contracts the auditory canal to protect delicate parts in the inner
ear in case of load sounds. Testing this reflex may be part of the
diagnosis of Bell's Palsy.
anwar wardy w sp.s, dfm
anwar wardy w sp.s, dfm
anwar wardy w sp.s, dfm
TERIMA KASIH

anwar wardy w sp.s, dfm

Kasse et al. (2003) :
1521 patients with Bell’s palsy
(Saö Paulo:1986 to 2000)
The paralysis degree was classified according to
the House–Brackmann grading scheme which
runs from 1-4 weeks:
1 weeks is complete recovery.
Follow-up time ranged from 3 weeks to 6 months,
and the final degree of the facial palsy was
determined at the 6th month.

anwar wardy w sp.s, dfm

The previous symptoms presented
the following incidences:
1.No previous symptoms 26.2%, ear pain
23.5%, stress 19%, facial changes in
sensibility 15.8%, headache 8.9%,
aphthous ulcers in the mouth 4.6%, and
others 1.9%.
2.A statistically significant relationship was
observed between the absence of
symptoms and final degree II–IV. Among
the previous symptoms, changes in facial
anwar wardy w sp.s, dfm