I had a patient before, he is 53 years old.. He went to the rehab
center for therapy. He had a problem with his face. The left side was
all weak, he can't even close his left eye. The physiatrist diagnosed
it as Bell's Palsy. He thought that it was just an ordinary facial
paralysis. "Bell's Palsy and Facial Paralysis is different", the
doctor said and he came up with comparison

POINTS of COMPARISON BELL'S PALSY FACIAL PARALYSIS

Etiology Unknown CVA, tumors,
vascular lesion

UMNL/LMNL Lower/LMNL Upper/UMNL

Type of lesion Peripheral Central

Distribution ipsilateral contralateral

Muscle tone Flaccid Spastic

Nerve affected Facial Nerve No specific nerve
(all)

Skin Condition Dry Dry

No one knows the cause of Bell's Palsy but there are some common
suspected causes:

- virus

- compression of nerve

- bacteria

- drugs

- cold temperature

- trauma of the facial nerve

- Pressure of facial nerve due to tumor

As a physical therapist this are the treatments I did:

1. Facial Massage for 5-10 minutes twice a day in a chin - forehead
direction to maintain the tone.

2. Infrared on the affected side to increase the blood supply and
decrease skin resistance before ES application.

3. Electrical Nerve Stimulation application to the nerve and muscle.

4. Hot moist pack to hasten recovery and relief of pain.

5. Patient Education and advice. Patient should lie down at intervals
to reduce the effects of gravity upon the paralyzed muscle. The eye
should be blinked regularly because the blink reflex is lost.

6. The most important of all is Facial Exercise. The patient should
do:

- Closing eyelids

- Frowning

- Expression of surprise

- Wrinkling of the nose

- Pursing of the lips

- Compresses the cheek against the teeth

- Blowing

- Smiling

That's it.. My patient was just treated for 3 weeks. And miracle
happened..