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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