This is patient AM, 28-year-old male who came in the ER because of drooping of his left face. He said he woke up and he could not move his left face.
He has no other muscle weakness. He is conscious and coherent although he had a little difficulty speaking because the left side of his lips drooped. He had normal blood pressure and he had no other co-morbidities. He was diagnosed to have Bell’s palsy. Name 5 muscles which are affected and list its actions. Describe the mechanism of his muscle weakness. What other symptoms could the patient exhibit as a result of facial muscle weakness?
5 Muscles affected by by Bell’s palsy:
Occipitofrontalis - elevate eyebrows; wrinkles skin of forehead skin horizontally; draws scalp with its occipital part
Orbicularis oculi - closes eye
Orbiculariis oris - controls the shape movement of the lips during speech; closes, protrudes, and compresses the lips against teeth
Buccinator - preserves the tightness of the cheeks and presses them against the teeth; assists the tongue to keep the bolus of food central in the oral cavity; draws corner of mouth laterally
Platysma muscles - draws outer part of lower lip inferiorly and posteriorly (pouting); depresses mandible
Mechanism of Bell’s palsy:
The facial nerve's inflammation leading to compression along this constrained section of the fallopian canal is the most likely cause of Bell's palsy. Initial loss of sensory or motor function is brought on by this inflammation, but later nerve degeneration may result.
Symptoms of Bell’s Palsy:
The symptoms of his facial weakness are having difficulty in speaking, eating, or drinking, drooling, dry eyes, experiencing facial or ear pain, headache, loss of taste, ringing in ears, sensitive to sounds, and changes in the amount of tears and saliva you produce.