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?
Name 5 muscles which are affected and list its actions.
- Muscle: Zygomaticus Major
Actions: Draws angle of mouth superiorly and laterally, as in smiling
- Muscle: Occipitofrontalis (frontal belly)
Actions: Draws scalp anteriorly, raises eyebrows, and wrinkles skin of forehead horizontally as in look of surprise
- Muscle: Orbicularis Oris
Actions: Closes and protrudes lips, as in kissing; compresses lips against teeth; and shapes lips during speech
- Muscle: Orbicularis Oculi
Actions: Closes eye
- Muscle: Buccinator
Actions: Presses cheeks against teeth and lips, as in whistling, blowing, and sucking; draws corner of mouth laterally; and assists in mastication (chewing) by keeping food between the teeth (and not between teeth and cheeks)
Describe the mechanism of his muscle weakness.
Bell's palsy is a condition that causes sudden weakness in the muscles on one side of the face. In most cases, the weakness is temporary and significantly improves over weeks. The weakness makes half of the face appear to droop. Smiles are one-sided, and the eye on the affected side resists closing.
What other symptoms could the patient exhibit as a result of facial muscle weakness?
- Facial droop and difficulty making facial expressions, such as closing your eye or smiling
- Drooling
- Pain around the jaw or in or behind your ear on the affected side
- Increased sensitivity to sound on the affected side
- Headache
- A loss of taste
- Changes in the amount of tears and saliva you produce