Face It

By Tashmika Ramsumer.

They say that you never forget your first patient as a student…they were right. My first patient with a neurological condition was a complete mystery. I remember feeling nervous as I entered the ward to treat her.

The visage of my patient Infront of me, whose symptoms could only be described as having a slightly drooping face and difficulty blinking. I remember her sweet half smile as I introduced myself as her treating physio. The impact of this patient’s diagnosis on her life, had not caused her to lose her sense of humour.

I remember leaving the ward feeling intrigued by this diagnosis! Who, what, where and how did Bell’s Palsy affect the neurological system? And how could I, a Physio, help those who lived with this condition?

So that night, I read as many articles as I could on the diagnosis & treatment of Bell’s Palsy. Here are my basic findings. I hope you find it as interesting as I did!

This is a neurological condition which causes sudden weakness or paralysis to one side of a patients face. This is a rapid and progressive condition which usually takes 72 hours to reach its peak. Common signs are drooping of the mouth, lower eyelid, eyebrow. Drooling may occur.

Other signs could be loss of sensation along one side of your face. And loss of taste on 2/3 of your tongue as it affects the facial nerve.

Research shows that it may be caused by viral infections which causes swelling of the facial nerve. Other causes may be due to trauma, neoplasm (abnormal cell growth) or autoimmune responses, but the most interesting fact is that the EXACT cause of Bell’s Palsy is unknown! Alas, a mystery still to be solved by ongoing research and treatment.

With this new found knowledge and a spring in my step, I bounced into the ward to start treatment with my patient.

Facial muscle exercises and a facial massage were the first parts of the treatment.

The facial exercises included:

  • eyebrow raises.
  • Sticking your tongue out.
  • Chewing
  • Bubble blowing
  • Flaring nostrils
  • Blowing kisses

I’m sure to others, it may have seemed like we were pulling funny faces at each other for no good reason while sharing a giggle or two! I assured the patient that it was a means to an end for the importance of these exercises was to stimulate the facial nerve.

An ice massage had proved very useful in my initial treatment. Ice massage helps to reduce inflammation along the facial nerve.
In more severe cases patients have responded well to lower intensity laser treatment. This is used to improve inflammation, reduce pain and to help with tissue regeneration.

This was one of my most memorable first cases. The more I researched, I become intrigued with Bells Palsy. I found an interesting article which looked at the benefits of electrical stimulation. The use of an EMS/TENS devices mimic the natural action of the facial muscles. Studies have shown the return of facial symmetry and activity in patients with Bells Palsy

If you, or your loved one, has been recently diagnosed with Bell’s Palsy, CW Physios has a wonderful team to assist you in treatment and management of this condition.