A Simple Guide to Facial Palsy, Diagnosis, Treatment, and Related Conditions

By Kenneth Kee

This book describes the Facial Palsy, Diagnosis and Treatment and Related Diseases

Facial Palsy is the pressure on the facial nerve causing paralysis
The cause is unknown but ranged from hereditary to sarcoidosis
The facial muscles on one side is weak and drooping
The eye cannot close properly and there is saliva dribbling

Bell’s Palsy is the most common form of Facial palsy
Smiling usually show up the presence of facial paresis
There is no definitive test available for Bell’s palsy
Physical signs and electromyogram determines the extent of the nerve paralysis

The face is crooked on one side with drooping of the lips
The eye on one side cannot close properly with out turned eyelids
There is blinking or tears in the eye while eating
There is dribbling of saliva and difficulty in talking

The treatment is to start urgently on a course of oral prednisolone
Physiotherapy of the facial muscles is used to restore the facial muscle tone.
The eyes need to be protected by wearing glasses or using eye ointment
Most patients will recover within 3 weeks of treatment

-An original poem by Kenneth Kee

Bell’s facial palsy is the most frequent cause of facial paralysis.

While early medical trials of mRNA COVID-19 vaccines reported a very small number of post-vaccine Bell’s facial palsy cases, later studies detected no relation between the two.

New treatment methods for facial palsy are Facial neuromuscular retraining, Botulinum toxin injection and surgery for post-paralytic syndrome.

Facial Palsy is the paralysis of the facial nerve (7th cranial nerve) from its origin in the brain right to the branches of the nerve in the face.

Bell palsy also termed idiopathic facial paralysis (IFP) is the most frequent cause of unilateral facial paralysis and the most frequent cause of facial paralysis worldwide.

When Facial Palsy happens, the function of the facial nerve is disrupted producing a disruption in the messages the brain transmits to the facial muscles.

This disruption leads to facial weakness or paralysis.

Facial Palsy involves only one of the paired facial nerves and one side of the face but rarely can affect both sides.

The cause of Facial palsy is unknown though the disease seems to be a polyneuritis with possible viral, inflammatory, autoimmune and ischemic causes.

The facial nerve becomes inflamed in reaction to the infection causing pressure within the Fallopian canal and leading to ischemia of the nerve cells.

The minimum diagnostic criteria for facial palsy are paralysis or paresis of all muscle groups on one side of the face, sudden onset and absence of CNS disease.

The most important part of the diagnosis is to distinguish between the supra-nuclear and infra-nuclear causes of facial palsy.

Supra-nuclear
The movements of the upper part of the face is not affected since the forehead muscles have bilateral cortical representations

Infra-nuclear
Weakness of facial muscle on 1 side, with drooping of the mouth on 1 side, sagging eyelids, difficulty in closing the eye.

Some Facial Palsy cases are mild and do not need treatment as the symptoms normally subside on their own within 2 weeks.

Treatment involves:
Corticosteroid therapy
Antiviral agents
Eye care: Topical ocular lubrication to prevent corneal drying, abrasion and ulcers
Physiotherapy

Surgical treatments are:
Facial nerve decompression
Subocularis oculi fat lift
Implantable devices in the eyelid
Tarsorrhaphy
Transposition of the temporalis muscle
Facial nerve grafting

TABLE OF CONTENT
Introduction
Chapter 1 Facial Palsy
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Trigeminal Neuralgia
Chapter 8 Intercostal Neuralgia
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Mar 8, 2023
• ISBN: 9798215785423

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Facial Palsy,

Diagnosis,

Treatment,

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2023 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes the Facial Palsy, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Facial Palsy)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Facial Palsy

(Chapter from A Simple Guide to Facial Palsy 2014 by Kenneth Kee)

Facial Palsy is the pressure on the facial nerve causing paralysis

The cause is unknown but ranged from hereditary to sarcoidosis

The facial muscles on one side is weak and drooping

The eye cannot close properly and there is saliva dribbling

Bell’s Palsy is the most common form of Facial palsy

Smiling usually show up the presence of facial paresis

There is no definitive test available for Bell’s palsy

Physical signs and electromyogram determines the extent of the nerve paralysis

The face is crooked on one side with drooping of the lips

The eye on one side cannot close properly with out turned eyelids

There is blinking or tears in the eye while eating

There is dribbling of saliva and difficulty in talking

The treatment is to start urgently on a course of oral prednisolone

Physiotherapy of the facial muscles is used to restore the facial muscle tone.

The eyes need to be protected by wearing glasses or using eye ointment

Most patients will recover within 3 weeks of treatment

-An original poem by Kenneth Kee

Bell’s facial palsy is the most frequent cause of facial paralysis.

While early medical trials of mRNA COVID-19 vaccines reported a very small number of post-vaccine Bell’s facial palsy cases, later studies detected no relation between the two.

Based on recent research, the risk of Bell’s facial palsy seems to be higher for those who develop COVID-19 as compared to those who get the mRNA vaccine.

What is Facial Palsy?

Facial Palsy is the paralysis of the facial nerve (7th cranial nerve) from its origin in the brain right to the branches of the nerve in the face.

Bell's palsy is the most frequent facial palsy with unknown cause, most likely due to viral infection of the facial nerve after the stylomastoid foramen

Bell's palsy is a type of transient facial paralysis occurring from injury or trauma to the facial nerve.

Bell palsy also termed idiopathic facial paralysis (IFP) is the most frequent cause of unilateral facial paralysis and the most frequent cause of facial paralysis worldwide.

It is one of the most frequent neurological disorders of the cranial nerves.

In most cases, Bell palsy slowly recovers over time.

There is mounting evidence that implicates herpes simplex type I and herpes zoster virus reactivation from cranial-nerve ganglia.

The facial nerve journeys through a narrow, bony canal (termed the Fallopian canal) in the skull, beneath the ear, to the muscles on each side of the face

For most of its journey, the nerve is sheathed in this bony shell.

Each facial nerve regulates the muscles on one side of the face such as those that control eye blinking and closing, and facial expressions such as smiling and frowning.

Also the facial nerve transmits nerve impulses to the lacrimal or tear glands, the saliva glands and the muscles of a small bone in the middle of the ear termed the stapes.

The facial nerve also provides taste sensations from the tongue.

Functions of Facial Nerve on facial muscles:

1. Raising the eyebrows (frontalis)

2. Closing the eyes (orbicularis oculi)

3. Frowning (corrugator)

4. Open mouth smiling (zygomaticus)

5. Closed mouth smiling (risorius)

6. Pouting (orbicularis oris)

7. Lifting top lip (levator labii)

8. Pulling lower lip down (depressor labii)

9. Sticking