Facial physical therapy, Bell's palsy of the facial nerve, treatment, Belgrade, Serbia.

Bell's palsy is a neurological disorder that affects the facial nerve (VII cranial nerve), which controls the muscles of the face. This condition causes weakness or paralysis of the muscles on one side of the face. Patients with this diagnosis cannot furrow their brow, close their eye, or move the part of the face affected by the paralysis. Additionally, there is often a drooping of the corner of the mouth on the affected side, further highlighting the asymmetry. Along with these primary symptoms, patients frequently experience insufficient tear production, which can lead to burning or dryness of the eye. There may also be disturbances in taste sensation and uncomfortable noise or ringing in the ear. This type of facial paralysis, encompassing these symptoms, is known as Bell's palsy.

Facial nerve

The facial nerve, or nervus facialis, is the seventh cranial nerve with a critically important function. It allows for the movement and motor control of the facial muscles, affects hearing, and plays a key role in the process of eating. Damage to this nerve can lead to serious functional, aesthetic, and psychological disturbances in individuals.

• Exposure to cold
• Viral infections
• Lack of sleep
• Physical trauma

The exact cause of Bell's palsy is not fully understood, but experts believe that certain factors and conditions may play a key role. One frequently mentioned cause is exposure to cold, particularly during driving or after sudden temperature changes, such as exposure of a warm body to cold air or drafts while the hair is wet. These factors are associated with an increased risk of developing Bell's palsy.

In addition to exposure to cold, viral infections are also thought to trigger Bell's palsy. Some of the viruses associated with this condition include Herpes simplex virus (HSV), which causes cold sores, and Varicella-zoster virus (VZV), the cause of chickenpox and shingles. These infections can lead to inflammation and swelling of the facial nerve, resulting in weakness or paralysis of the facial muscles. Individuals with weakened immune systems due to stress, lack of sleep, physical trauma, or autoimmune diseases may be more susceptible to developing Bell's palsy. Bell's palsy most commonly affects one side of the face. The face becomes paralyzed and "droops," causing an inability to raise the eyebrow, corner of the mouth, furrow the brow, or close the eye on the affected side. Within 48 hours of the initial symptoms, such as slight tingling and numbness of the face, complete or partial paralysis of the face can occur.

This condition is often accompanied by severe pain behind the ear, but it is usually not associated with other neurological symptoms. It is more common in men, though it can also affect women, especially during pregnancy.

Treatment of Bell's Palsy

Treatment of Bell's Palsy depends on the cause of the condition, but it is important to start therapy as soon as possible to restore facial nerve function quickly.

Treatment of Bell's Palsy involves several approaches, including medications, physical therapy, and, in more severe cases, surgical interventions. Corticosteroid medications are often the first step in therapy and are used to reduce inflammation and swelling. Treatment with these medications may last several months, depending on the severity of symptoms and the speed of recovery.

In cases of complications, such as ectropion (outward turning of the lower eyelid), surgical treatment may be necessary. Surgical procedures may include releasing pressure on the nerve, nerve repair, or reconstructive surgeries to restore facial function.

Physical therapy is a crucial part of treatment and includes a range of different procedures and techniques. These may include:

• Manual lymphatic drainage: Helps reduce swelling and improve circulation.
• Temporomandibular joint treatment: Eases tension and pain in the joint.
• Craniosacral therapy: Focuses on improving the function of the nervous system through manipulation of the head and spine.
• Neurophysiotherapy: Includes specialized techniques to improve nervous system function.
• Myofascial mobilization: Aims to improve muscle and fascia mobility.
• Acupressure: Uses pressure on specific points to relieve symptoms.
• Intention and strengthening exercises: Focused on restoring strength and control of facial muscles.
• Sensory treatment: Improves sensory perception and facial function.
• Magnetic therapy and electrotherapy: Includes muscle stimulation, TENS (transcutaneous electrical nerve stimulation), and therapeutic laser for stimulating muscles and nerves.

An essential part of physical therapy is also electrical stimulation of the affected side of the face, as well as performing exercises in front of a mirror to improve coordination and muscle function.

Although Bell's Palsy usually resolves within 6 months, some patients may experience symptoms for a longer duration, and occasionally chronic weakness may occur. In rare cases, the nerve may be permanently damaged. Therefore, it is important to understand the seriousness of this condition and to address treatment in a timely manner.

Our experience in treating Bell's Palsy shows that the application of comprehensive physical therapy often yields very satisfactory results. Our patients typically progress quickly and return to their daily activities with improved facial function.