Bell's Palsy

[khaing thazin oo]

hi physios,

i wanna to know motor point for electrical stimulation in mouth in facial palsy.My patient recover all area but they have problem in mouth.they mouth were move to sound side,After 4 session of treatment with electical stimulation other part were recover but mouth is still left.I wanna to know how treatment is give.

[jjose_01]

from the corner of the eye, you go down to the upper cheek, you must feel where there is contraction in both the eye and upper corner of the mouth, take time stimulating at that point, the more and harder the contrations, the better.
then go down to the point between the corner of the nose and the corner of the mouth.
then go to the corner of the mouth, go laterally and down, feel the platysma contracting, but dont go down to prevent stimulating vasovagal reflex. go up and laterally keeping contractions of the corner of the mouth and go up to your main motor point which is near the ear and the corner of the eye.

your main exercise is very hard to instruct to the patient, so keep a mirror with you. let him to feel how his normal side corner of his mouth move fast, then, let him try to move it fast but not hard keeping his normal side not contracting.

you must not let his teeth grind as he do this, never instruct him to chew a gum, you are stimulating CNIII not VII.

let him to try to see his upper then his lower teeth then his molars. when he is showing you his lower teeth, look for the platysma.

next is to let him hold his lips on his normal side close then you will try to open it with your fingers, then at the center of his lips, then at his involved lips.

then let him to hold air inside of his cheeks, don't let him hold his lips, just let the air out, it's one way for him to know if he is getting better or not. but others let him to hold his lips just to stretch the muscles, but i dont know their reasons.


i hope you get what i mean, as i said at my reply back up, bells palsy is very easy to treat, that even without electrotherapy or even PT, it will become okey, what we do is just let him to feel every movement that was lost/impaired as he go through the natural healing process.