Pennsylvania Nurse, Front Page 2017 Issue 3 | Page 13

Conclusion
BP is an attack of the facial
nerve. It is idiopathic because
there is no consensus in the medi-
cal and scientifi c community as to
what causes the condition. Latent
herpes has been implicated as a
primary cause (Mooney, 2013).
Clinicians must be aware of the
disease process and differential
diagnoses that present similarly
because it mimics other known
causes of facial paralysis.
Priority should be given to check-
ing the patient’s blood glucose,
performing a neurological exam,
and gathering the patient’s past
medical history, including family
history of BP. Research shows
a genetic component to getting
BP if other family members were
affl icted.
ing on the closed eye at bedtime.
Finally, patients who have de-
pression or display anxiety over
acute facial disfi gurement should
receive information for follow-up
psychological counseling.
BP was described more than two
centuries ago. However, questions
still exist to its true etiology and
related pathophysiology. Scientifi c
theory and evidence-based re-
search have allowed medical staff
to tailor increasingly effective
treatment of patients affl icted
with this condition to minimize
the residual effects of the disease.
Acute onset of BP can be scary
for patients. RNs should become
knowledgeable about the disease
process and treatment options to
reassure, educate, and properly
care for their patients.
References
Treatment and management op-
tions generally include the use of
steroids within 72 hours of onset
to prevent long-term sequelae
(Mooney, 2013). The use of antivi-
ral medications alone is not effec-
tive in limiting the disease pro-
cess. When prescribed, antiviral
medications should be taken with
steroids. Experts have recom-
mended against the routine use of
CT scans and blood work in most
clinically diagnosed cases of BP.
However, clinicians must use a
combination of clinical judgment,
training, and institutional policy
to provide care for the patient.
The RN should screen the pa-
tient for dysphagia. Care must be
taken to rehydrate the affected
eye regularly with eye drops or
ointment. It should be protected
from trauma with glasses during
the day and carefully placed tap-
American Heart Association. (2011). Target:
Stroke [Assessment guide]. Retrieved from
http://www.strokeassociation.org/idc/groups/
stroke-public/@wcm/@hcm/@sta/documents/
downloadable/ucm_454087.pdf
Aminoff, M. J. (2017). Sir Charles Bell: His
life, art, neurological concepts, and controversial
legacy. New York, NY: Oxford University
Press.
Baugh, R. F., Basura, G. J., Ishii, L. E.,
Schwartz, S. R., Drumheller, C. M., Burk-
holder, R., & ... Vaughan, W. (2013). Clinical
practice guideline: Bell’s palsy executive sum-
mary. Otolaryngology-Head and Neck Surgery:
Offi cial Journal of American Academy of
Otolaryngology-Head and Neck Surgery, 149(5),
656-663. doi:10.1177/0194599813506835
Cawthorn, T. (1965, May). Idiopathic facial
palsy. Pathological and surgical treatment.
Archives of Otolaryngology, 81, 494.
Clement, W., & White, A. (2000). Idiopathic
familial facial nerve paralysis. Journal of
Laryngology and Otology, 114, 132-134.
Daqiang, Q., Zhiyuan, O., & Wei, L. (2009). Fa-
milial recurrent bell's palsy. Neurology India,
57(6), 783-784. doi:10.4103/0028-3886.59478
Eryilmaz, A., Basal, Y., Tosun, A., Kurt
Omurlu, I., & Basak, S. (2015). The neutrophil
to lymphocyte ratios of our pediatric patients
with Bell’s palsy. International Journal of Pe-
diatric Otorhinolaryngology, 79(12), 2374-2377.
doi:10.1016/j.ijporl.2015.10.047
Frock, T., & McCaffrey, R. (2005). Clinical case
report. Postauricular pain with Bell’s palsy.
Nurse Practitioner, 30(4), 58-61.
Fu, L., Bundy, C., & Sadiq, S. A. (2011).
Psychological distress in people with disfi gure-
ment from facial palsy. Eye, 25(10), 1322-1326.
doi:10.1038/eye.2011.158
Fujiwara, T., Matsuda, S., Tanaka, J., & Hato,
N. (2017). Facial paralysis induced by ear in-
oculation of herpes simplex virus in rat. Auris
Nasus Larynx, 44(1), 58-64. doi:10.1016/j.
anl.2016.04.002
Gagyor, I., Madhok, V. B., Daly, F., Somasun-
dara, D., Sullivan, M., Gammie, F., & Sullivan,
F. (2015). Antiviral treatment for Bell’s palsy
(idiopathic facial paralysis). The Cochrane Da-
tabase of Systematic Reviews, (11), CD001869.
doi:10.1002/14651858.CD001869.pub8
Gilden, D. H. (2004). Bell’s palsy. New England
Journal of Medicine, 351(13), 1323-1331.
Glober, N. K., Sporer, K. A., Guluma, K. Z.,
Serra, J. P., Barger, J. A., Brown, J. F., …
Salvucci, A. A. (2016). Acute stroke: Cur-
rent evidence-based recommendations for
prehospital care. Western Journal of Emergency
Medicine, 17(2), 104-128.
Halioua, R. L., Williams, R. T., Murray, N.
P., Skalko, T. K., & Vogelsong, H. G. (2011).
Staring and perceptions of people with facial
disfi gurement. Therapeutic Recreation Journal,
45(4), 341-356.
Harirchian, M., Sarrafnejad, A., Ghelichnia,
M. & Ghaffarpour, H. (2008). Herpes simplex
virus in saliva of patients with Bell’s palsy.
Acta Medica Iranica 46(1), 5-10.
Harvard Women’s Health Watch (2010, Janu-
ary). What to do about Bell’s palsy: Recovery
takes time, patience, proper eye care, and maybe
a medication. Retrieved from https://www.
health.harvard.edu/newsletter_article/what-
to-do-about-bells-palsy
Hultcrantz, M. (2016). Rehabilitation of Bell’s
palsy from a multi-team perspective. Acta Oto-
Laryngologica, 136(4), 363-367. doi:10.3109/000
16489.2015.1116124
Kefalidis, G., Riga, M., Argyropoulou, P.,
Katotomichelakis, M., Gouveris, C., Prasso-
poulos, P., & Danielides, V. (2010). Is the width
of the labyrinthine portion of the fallopian
tube implicated in the pathophysiology of
bell's palsy? A prospective clinical study using
computed tomography. Laryngoscope, 120(6),
1203-1207. doi:10.1002/lary.20896
Kuehner, C. (2003). Gender differences in
unipolar depression: An update of epidemio-
logical fi ndings and possible explanations . Acta
Psychiatrica Scandinavica, 108(3), 163-174.
doi:10.1034/j.1600-0447.2003.00204.x
Madhok, V., Gagyor, I., Daly, F., Somasun-
dara, D., Sullivan, M., Gammie, F., & Sullivan,
F. (2016, July 18). Corticosteroids for bell's
palsy (idiopathic facial paralysis). Cochrane
Database of Systematic Reviews, 2016(7).
doi:10.1002/14651858.CD001942.pub5
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