Dr. Sunil Nigam

Facial paralysis can happen due to many factors. Sometimes inflammation develops around the facial nerve as it passes through the skull from the brain. This presses on the nerve and makes it stop functioning. As the nerve stops functioning, so does the muscle it controls.

This is what happens in Bell’s palsy, the most common cause of facial paralysis.

Bell’s palsy can happen to anyone and its cause is, hold your breath, a viral infection. Herpes zoster, Varicella zoster and HIV viruses can cause Bell’s palsy.

Bell's palsy is a common cause of a facial paralysis but there are many others too that affect or damage facial nerve. These include head injury, sarcoidosis, lyme disease, growths in the ear, tumours in the parotid gland, brain tumors and stroke.

The weakness of the face usually one-sided is a symptom of Bell’s palsy. The face may droop to one side, chewing food is also tough, drooling, dry eyes and difficulty wrinkling forehead and speech are other symptoms of Bell’s palsy, the most common reason for facial paralysis.

Treatment:

The type of therapy you receive for facial paralysis will depend on its cause. It will also develop on how long you’ve suffered from facial paralysis and the extent of damage to the facial nerve.

Your physiotherapist can help and so can speech and language therapists to deal with the issue.

In physiotherapy, a treatment called 'facial retraining' with facial exercises helps with facial palsy. It is important that you seek help from a therapist who specialises in facial rehabilitation only.

This is what you can expect from facial rehabilitation therapy-

1. Exercises for eye care

2. Exercises for dry mouth management

3. Exercises to make drinking and eating easier

4. Speech therapy

Your physiotherapist will educate you on how the facial nerve works and how it recovers. This is important to make you recover. A home therapy programme plays an important role too. It includes massages to keep face muscles mobile and healthy, stretches to lengthen muscles, exercises to help re-learn balanced facial movements and relaxation of your facial nerve and muscles.

The physiotherapist will work on your facial movement to make muscles fit. The basic idea is to slowly rewire the brain-to-nerve-to-muscle pathway. The physiotherapist’s first step is to retrain you to do correct movements voluntarily, while mentally focusing on the movement.

Physiotherapy may take months but keep at it to recover completely, especially the home exercises.

Injections of botulinum toxin or Botox also help especially if you suffer from spasms in facial muscles. Surgery is also an option for chronic cases.

Remember that exercises should be done gently as well as daily to reap benefits. Always do these exercises with the help of a therapist only. Doing exercises by yourself can be counter- productive.

Paralysis can be concluded as the state when the muscles lose functioning in any part of the body. Any kind of disruption in our nerve system can be responsible enough to cause paralysis. Our central nervous system and peripheral nervous system communicate and control our senses of movement. But interruption in nerve impulses can cause weakness in muscles which leads to muscle paralysis.

Symptoms
A paralysed patient will encounter symptoms like:

1. Decreasing the motor power
2. Decreasing vasomotor control
3. Loss of sensation
4. Decreasing bowel and bladder control
5. Losing the ability of sexual function.

When it comes to treating a paralysis patient, physiotherapy is proven to be the best remedy. Physiotherapy has thoroughly helped patients with paralysis in getting to feel confident and independent. Physiotherapy includes various exercises and techniques which are developed with time in order to provide a complete rehabilitation to the patients.

Types of paralysis:
There are mainly four types of paralysis

1. Monoplegia: when one limb gets paralysed
2. Hemiplegia: when arm and leg of a single side get paralysed
3. Paraplegia: when legs get paralysed
4. Quadriplegia: when both sides get paralysed

Treating paralysis with physiotherapy

1. Physiotherapy is advised to patients with any type of paralysis. It should be started soon in order to improve blood circulation in the muscles. It also helps in relaxing the stiff muscles. This treatment improves the overall health condition of the patient.
2. Physiotherapy is also responsible for reducing any kind of swelling which takes place due to external brain injury.
3. Physiotherapy is helpful in making the patient stable and independent.
4. It also helps in maintaining the blood pressure.
5. It helps to improve the respiratory system.
6. Physiotherapy maintains the affected muscles and nerves. It provides strength to the affected muscles and works to prevent the limbs from getting deformed.
7. One major symptom of paralysis is a loss of bladder and bowel function. Physiotherapy helps in managing the paralysed bowel and bladder.
8. Physiotherapy involves different techniques which can be learnt from a physiotherapist in order to transfer a paralysed patient.
9. Othorsis, canes, braces, splints are the equipment that are advised to the patient by a professional physiotherapist.
10. Physiotherapy helps in resolving problems such as anxiety, anger, depression, denial which takes place after post-paralysis mental trauma.
11. Physiotherapist provides safeguarding tips to the patient and his or her family in order to avoid accidents.
12. Physiotherapy has a big role in creating the motivation in patient's mind.

These are the benefits of physiotherapy which help the paralyzed limbs getting stronger and better. But it is always advised to be done under a professional physiotherapist.