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The patient was given a diagnosis of Bell’s palsy. Women who develop Bell’s palsy in pregnancy have a 5-fold increased risk of preeclampsia or gestational hypertension.
The etiology of Bell’s palsy is unknown, but one prevailing theory suggests a viral etiology from the herpes family. The facial nerve becomes inflamed, resulting in nerve compression. Compression of the facial nerve compromises muscles of facial expression, taste fibers to the anterior tongue, pain fibers, and secretory fibers to the salivary and lacrimal glands.
This patient’s FP talked to her about treatment with steroids and antivirals. She chose not to take medications because of her pregnancy. She was told to use eye lubricants to keep her left eye moist. Though she experienced some improvement after delivery, she continued to have Bell’s palsy.
She was subsequently referred to an ear, nose, and throat surgeon who was experienced in the specialized surgical procedures needed to restore facial movement (regional muscle transfer and microvascular free tissue transfer).
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Chumley H. Bell’s palsy. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:979-981.
To learn more about The Color Atlas of Family Medicine, see:
• http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
You can now get The Color Atlas of Family Medicine as an app for mobile devices including the iPhone, iPad, and all Android devices by clicking this link:
The patient was given a diagnosis of Bell’s palsy. Women who develop Bell’s palsy in pregnancy have a 5-fold increased risk of preeclampsia or gestational hypertension.
The etiology of Bell’s palsy is unknown, but one prevailing theory suggests a viral etiology from the herpes family. The facial nerve becomes inflamed, resulting in nerve compression. Compression of the facial nerve compromises muscles of facial expression, taste fibers to the anterior tongue, pain fibers, and secretory fibers to the salivary and lacrimal glands.
This patient’s FP talked to her about treatment with steroids and antivirals. She chose not to take medications because of her pregnancy. She was told to use eye lubricants to keep her left eye moist. Though she experienced some improvement after delivery, she continued to have Bell’s palsy.
She was subsequently referred to an ear, nose, and throat surgeon who was experienced in the specialized surgical procedures needed to restore facial movement (regional muscle transfer and microvascular free tissue transfer).
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Chumley H. Bell’s palsy. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:979-981.
To learn more about The Color Atlas of Family Medicine, see:
• http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
You can now get The Color Atlas of Family Medicine as an app for mobile devices including the iPhone, iPad, and all Android devices by clicking this link:
The patient was given a diagnosis of Bell’s palsy. Women who develop Bell’s palsy in pregnancy have a 5-fold increased risk of preeclampsia or gestational hypertension.
The etiology of Bell’s palsy is unknown, but one prevailing theory suggests a viral etiology from the herpes family. The facial nerve becomes inflamed, resulting in nerve compression. Compression of the facial nerve compromises muscles of facial expression, taste fibers to the anterior tongue, pain fibers, and secretory fibers to the salivary and lacrimal glands.
This patient’s FP talked to her about treatment with steroids and antivirals. She chose not to take medications because of her pregnancy. She was told to use eye lubricants to keep her left eye moist. Though she experienced some improvement after delivery, she continued to have Bell’s palsy.
She was subsequently referred to an ear, nose, and throat surgeon who was experienced in the specialized surgical procedures needed to restore facial movement (regional muscle transfer and microvascular free tissue transfer).
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Chumley H. Bell’s palsy. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:979-981.
To learn more about The Color Atlas of Family Medicine, see:
• http://www.amazon.com/Color-Atlas-Family-Medicine/dp/0071474641
You can now get The Color Atlas of Family Medicine as an app for mobile devices including the iPhone, iPad, and all Android devices by clicking this link: