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?
Some of the muscles that can be affected are the following five:
1. Orbicularis oculi: closes the eyes
2. Orbicularis oris: Closes and protrudes lips, as in kissing; compresses lips against teeth; and shapes lips during speech.
3. Levator labii superioris: Raises upper lip
4. Levator labii inferioris: Depresses lower lip
5. Occipitofrontalis: Draws scalp anteriorly, raises eyebrows, and wrinkles skin of forehead horizontally as in a look of surprise.
The mechanism behind Bell’s palsy—why facial muscles droop—is concerned when the facial nerve (cranial nerve vii) becomes injured or stops working properly on one side of the face. This may be the result of the facial nerve being compressed at the geniculate ganglion.
According to the Mayo Clinic, symptoms of Bell’s Palsy apart from drooping may include:
1. Drooling
2. Facial paralysis on one side of the face
3. Loss of taste
4. Pain around the jaw or in or around the ear on the affected side
5. Headaches