Steven Pavlakis MD http://www.TheDoctorsVideos.com Medical School Brown University Resident Fellowship Columbia Presbyterian Medical Center Chief of Pediatric Neurology; Maimonides Medical Centersbell,palsy,pediatrics,
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Host: Some people come to pediatricians and they notice the eye and one side is drooping and the mouth seems to go to one side, makes it a Bell’s palsy, what is a Bell’s palsy? Male Speaker: A Bell’s palsy is a new answer of facial weakness and it's felt to be a problem with a nerve that comes out of the lower part of the skull that goes to the muscles of the face on one side. Those muscles include the forehead, the eye muscles, the muscles that help close the eye, the muscles of the cheek and the chin, and the muscles that help us cry and smile on that one side. So if one gets a Bell’s palsy, they will have a weakness of all those muscles because of the nerve being inflamed. Bell’s palsys occur in shoulder, they occur in jaws as well. When a child gets a Bell’s palsy, it’s almost invariably -- if not invariably, makes a very good to perfect recovery. It is very, very, very rare for a child have a Bell’s palsy that does not get better over weeks to months. Sometimes it can take eight months, typically takes a month or two, but most children make a full to very near a full recovery without treatment indeed. Host: What’s the cause of Bell’s palsy? Male Speaker: No one knows but it’s felt to be an inflammation. Some of them are probably caused by viruses, occasionally it can be caused by Lyme disease and in certain parts of the country if one gets a Bell’s palsy, a Lyme titer is obtained. Sometimes in certain parts of the country, you might just treat for Lyme disease until you know if it’s Lyme disease, although the treatment for Bell’s palsy Lyme is somewhat controversial and there is a different set of approaches to that. But most Bell’s palsys in children probably don't need treatment very often if you have a very complete Bell’s and it’s the first two days. Some doctors will give steroids for a week or two but children do very well in contrast with adults, who have a very high rate of permanent facial weakness, which can be cosmetic and really can affect someone. Children do very well and furthermore most children once they have the Bell’s and recover do not have a recurrence, only 3% will go on and have a second affect. Host: Thank you.

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