Physical Therapy

I had a patient before, he is 53 years old.. He went to the rehabilitation center for therapy. He had a problem with his face. The left side was all weak, he can’t even close his left eye. The physiatrist diagnosed it as Bell’s Palsy. He thought that it was just an ordinary facial paralysis. “Bell’s Palsy and Facial Paralysis is different”, the doctor said and he came up with comparison

POINTS of COMPARISON     BELL’S PALSY    FACIAL PARALYSIS

Etiology                              Unknown              CVA, tumors, vascular lesion’

UMNL/LMNL                       Lower/LMNL        Upper/UMNL

Type of lesion                     Peripheral            Central

Distribution                        ipsilateral             contralateral

Muscle tone                        Flaccid                  Spastic

Nerve affected                    Facial Nerve       No specific nerve (all)

Skin Condition                     Dry                       Dry

No one knows the cause of Bell’s Palsy but there are some common suspected causes:

– virus

– compression of nerve

– bacteria

– drugs

– cold temperature

– trauma of the facial nerve

– Pressure of facial nerve due to tumor

As a physical therapist this are the treatments I did:

1. Facial Massage for 5-10 minutes twice a day in a chin – forehead direction to maintain the tone.

2. Infrared on the affected side to increase the blood supply and decrease skin resistance before ES application.

3. Electrical Nerve Stimulation application to the nerve and muscle.

4. Hot moist pack to hasten recovery and relief of pain.

5. Patient Education and advice. Patient should lie down at intervals to reduce the effects of gravity upon the paralyzed muscle. The eye should be blinked regularly because the blink reflex is lost.

6. The most important of all is Facial Exercise. The patient should do:

– Closing eyelids

– Frowning

– Expression of surprise

– Wrinkling of the nose

– Pursing of the lips

– Compresses the cheek against the teeth

– Blowing

– Smiling

That’s it.. My patient was just treated for 3 weeks. And miracle happened..