Case Report - Asian Journal of Biomedical and Pharmaceutical Sciences (2022) Volume 12, Issue 87

Use of mirror therapy and PNF in bells palsy - Case report.

Muzahid k Sheikh^1*, Bulbul Bhagikhaye², Milind Kahile³, Shailesh Patil⁴, Shriram Kane⁵, Pratibha Dawande⁶, Amol Gaikwad⁷

¹Assistant Professor Datta Meghe College of Physiotherapy Nagpur, India

²Student Datta Meghe College of Physiotherapy Nagpur, India

³Asso Professor, Datta Meghe College of Physiotherapy Nagpur, India

⁴Asso Professor, Datta Meghe College of Physiotherapy Nagpur, India

⁵Professor Department of Medicine Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences Sawangi (Meghe) Wardha, India

⁶Professor Department of Pathology Datta Meghe Medical College, Shalinitai Meghe Hospital and Research centre, Nagpur, India

⁷Information Technology Assistant Professor, Yeshwantrao Chavan College of Engineering, Nagpur, India

*Corresponding Author:

Muzahid k Sheikh
Assistant Professor Datta Meghe College of Physiotherapy Nagpur
India
E-mail: muzahid55@gmail.com

Received: 02-Mar-2022, Manuscript No. AABPS-22-58461; Editor assigned: 04-Mar-2022, Pre QC No. AABPS-22-58461(PQ); Reviewed: 18-Mar-2022, QC No. AABPS-22-58461; Revised: 21-Mar-2022, Manuscript No. AABPS-22-58461(R); Published: 28-Mar-2022, DOI:10.35841/2249-622X.87.113

Citation: Sheikh MK, Bhagikhaye B, Kahile M, et al. Use of mirror therapy and PNF in bell’s palsy -case report. Asian J Biomed Pharmaceut Sci. 2022;12(87):113

Abstract

Bell’s palsy is a neurological condition involving VII Cranial nerve characterized by facial drooping and weakness. This is a case study on Bell’s palsy involving 32-year old women, Mrs. who was referred to physiotherapy (PT). The patient reported primary complaints of difficulty drinking, drooling of saliva, trouble speaking clearly and right eye dryness. Cranial Nerve VII examination findings found right sided facial droop and drooping at the corner of her right eye and right side of her mouth. The PT intervention included patient education, facial muscle strengthening, mirror therapy, PNF exercises. Following PT intervention, Mrs. G increased her facial muscle strength, with a near complete recovery at 2 weeks, and was discharged from PT. In the future, more high quality research and evidence is needed to support the role of PT in treating Bell’s palsy

Keywords

Bell s palsy, Ear infection, Drooling, Mirror therapy.

Introduction

Bell's palsy is an acute-onset peripheral facial neuropathy and is the most common cause of lower motor neuron facial palsy. It can occur at any age, but it is most common between 15-60 years of age, and is believed to be a possible reaction to a viral infection that causes inflammation and swelling to CN VII that occurs in 11–40 cases per 100,000 annually [1- 3] recent studies have shown that neuromuscular retraining is effective in treating people with palsy. [4,5] PNF provides outpatient rehabilitation programs to help patients regain symmetrical facial expressions and ease or eliminate speech and swallowing problems.

This case study describes a patient with Bell’s palsy who presents with moderate-severe symptoms of facial drooping and weakness on the right side leading to difficulties with drinking, speaking and controlling the muscles of facial expression. This report aims to describe methods for testing and managing Bell’s palsy and help physiotherapist create a treatment plan in the absence of high-quality evidence.

Patient information

• Name-G

• Age - 34

• Gender – Female

• Occupation – Farmer (own field)

• Dominance – Right

• Address – Wanadongri

Chief complaint – Drooling of saliva from left corner of mouth, smiling, difficulty in drinking water, unable to close left eye, trouble speaking clearly, left side facial weakness. Social History: Works as a farmer in her field. Lives with her husband who is a farmer, with 2 children in a 2-story home.

History of Present Illness

A 34 year old female farmer by occupation had a complain of pain in her right ear which was disturbing her associated with slight difficulty in closing her eyelids, she then visited hospital where Dr. prescribe her some medication and eye drops which should be continued for 3-4 days [6]. Foe that week she started experiencing difficulty in facial expression, drooling of saliva not able to smile and puff the cheeks, she then again visited the hospital and after some diagnosis Dr. diagnosed she as a case of Bell’s palsy associated with recent ear infection. She was then prescribed with some other medications and referred her to take physiotherapy treatment. As a result of her symptoms she is complaining with drooling of saliva, unable to close left eye, trouble speaking, smiling.

Diagnostic Assessment

• Patient profile- 34 year old female

• Present illness- drooling of saliva, unable to close left eye, trouble speaking, smiling

• Social history-farmer by occupation lives with her husband, 2 children

• Observation: Facial droop on left side, drooping at corner of left eye and left side of the mouth

CN VII testing

• Sensation testing: Taste to anterior 2/3 of tongue-intact

• Test: cotton swab dipped in salt vs sugar (Table 1)

Table 1. CN VII Testing.

Outcome measure

House-Trackman Facial Nerve Scale: grade 4 (moderately severe dysfunction)

a) Forehead – grade 4 ( obviously weakness or disfiguring asymmetry)

b) Eye – grade 4 ( incomplete eye closure )

c) Mouth – grade 4 (asymmetry at rest)

Functional status

Speech slightly slurred, noticeable effort when talking.

Physiotherapy diagnosis

This case presented a patient, Mrs Age 32, with a diagnosis of Bell’s palsy, who presented with acute left -sided facial muscle weakness and facial droop, dry eye and functional difficulty with speaking and drinking. Her facial weakness is classified as moderately severe on the House-brakeman facial nerve scale. The patient’s primary concerns were eye pain, functional difficulties with speaking and drinking and closing left eye (Table 2) (Table 3).

Table 2. Problem List.

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