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Facial Palsy Medicine Neurology Physiotherapy

Management and Complications of Facial Palsy

In this article we will discuss the Management and Complications of Facial Palsy

In this article, we will discuss the Management and Complications of Facial Palsy. So, let’s get started.

Management

• Drugs-Steroids, vasodilators, antivirals
• Vitamin ‘B’ complex
• Protection of the eye – Goggles, eye drops
• Splinting to prevent mouth deviation
• Electrical stimulation to maintain the property of the muscles
• Active exercises\massage – Massage manipulations on the face may include Effleurage, kneading, wringing, hacking, tapping and stroking
• PNF – Kabat rehabilitation
• IRRI\SWD- to reduce oedema, pain
• Surgery – Facial nerve Decompression

(**Frequency of treatment: It differs according to the severity and prognosis of each patient. However, it is suggested that 1st month 3 sessions per week; 2nd month two sessions per week; 3rd month once a week)

Complications

• Residual paralysis
• Keratitis
• Synkinesis – the unwanted movements that occur during volitional & spontaneous movements
• Tics and spasms
• Crocodile tears in the eye
• Frey’s syndrome “gustatory sweating”
• Psychological and social stigma

Good Prognostic Factors

• Satisfactory recovery of facial paralysis was reported to achieve grade 1 or 2 on the House-Brackmann Grading System
• Signs of early recovery

Bad Prognostic Factors

• Complete facial palsy
• Poor or no response to NET on the affected side
• No recovery by 3 weeks
• Patients who exhibit grade 4 and above on HB scale after 1 month
• Age over 60 years
• Ramsay Hunt syndrome (Herpes Zoster virus)
• Associated conditions-Hypertension, diabetes, pregnancy and obesity
• Severe degeneration of the facial nerve shown by electrophysiological testings

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