Possibilities of pfysiotherapy in facial nerve paresis

The bachelor thesis addresses paresis of the facial nerve. The facial nerve paresis is a rather common illness, which cannot be often cured without consequences despite all the modern treatments. The paresis of the facial nerve occurs in two forms, central and peripheral. A central paresis is a result of a lesion located above the motor nucleus of the facial nerve. A peripheral paresis is caused by a lesion located either in the location of the motor nucleus or in the course of the facial nerve. The most common cause of a unilateral peripheral paresis is Bells idiopathic palsy. The peripheral paresis of the facial nerve manifests itself by a palsy of muscles of facial expression. The whole half of the face has its wrinkles smoothened, including forehead wrinkles, wrinkles between the nose and the lip and wrinkles between the chin and the lip. Furthermore, a ptotic mouth corner and lagophthalmos are among the symptoms. The central paresis is most commonly a result of a cerebrovascular accident and its symptoms will appear only on the bottom half of the face, contralaterally to the point of the lesion. The ptotic mouth corner is most apparent on the affected half of the face. The prognosis depends mainly on the etiology of the illness, but not all patients recover without consequences. I address the anatomy, physiology and pathophysiology of the facial nerve in the theoretical part of the thesis, including the possible treatments and the prognosis of the illness. The aim of this thesis is to offer a comprehensive view on the topic of paresis of the facial nerve from the viewpoints of its possible causes, its treatments, determination and realization of a physiotherapeutic plan for a patient with a paresis of the facial nerve. A qualitative research method was used in the practical part. History-taking, visual examination, palpation and muscle testing of motor functions of the muscles of facial expression according to Janda were used for the evaluation of the therapy of paresis of the facial nerve on the monitored subjects. The participants were three patients with a paresis of the facial nerve. The therapy included application of warmth, a facial massage, facilitation and reeducation of individual muscles according to Sister Kenny, the use of biofeedback elements and the application of a kinesio tape. The duration of the therapy was five weeks for patient no. 1 and no. 3 and eight weeks for patient no. 2. The results are included in the form of case historie