Medical Surgical Bell’s Palsy and Trigeminal Neuralgia #2

Question

A nurse is caring for a client with damage to cranial nerve VII after a shingles infection. Which assessment finding is associated with this condition?

Answers

  1. Severe pain to the mouth and jaw
    • Rationale:

      This answer is not correct because severe pain to the mouth and jaw is an assessment finding for trigeminal neuralgia. Trigeminal neuralgia is a sensory disorder of cranial nerve V.

  2. Progressive weakness of facial muscles
    • Rationale:

      This answer is not correct because Bell’s Palsy does not bring about progressive weakness, it causes paralysis. Guillain-Barre syndrome is an infection of the cranial and peripheral nerves that can cause gradual weakness of the facial muscles.

  3. Tremors in hands and fingers
    • Rationale:

      This answer is not correct because tremors in hands and fingers are a symptom of Parkinson’s disease. Parkinson’s disease is a neurodegenerative disease which affects movement.

  4. Paralysis of one side of face
    • Rationale:

      This answer is correct because cranial nerve VII controls the muscles responsible for facial expression. This is called Bell’s Palsy and sometimes follows a viral infection such as shingles, mononucleosis, or herpes simplex virus. Facial paralysis to one side of the face occurs temporarily as a result, and causes facial asymmetry.

Overview

Damage to cranial nerve VII after an infection is indicative of Bell’s Palsy and often results in temporary paralysis to one side of the face.

Explanation

Learning Outcomes

Bell’s palsy is a temporary facial paralysis which occurs from damage to cranial nerve VII. This cranial nerve controls the muscles responsible for facial expression. It typically presents after a viral infection. Symptoms include facial asymmetry due to facial paralysis to one side of the face, inability to smile or frown, or close eyelids, laxity to facial muscles, earache, and sometimes loss of taste. Treatment interventions include protecting the eyes from corneal damage due to clients being unable to close lids. Drops or ointments may be applied to protect the eyes from dryness. Corticosteroids for edema and inflammation are utilized to minimize nerve damage and antiviral agents are used to promote recovery. Complete resolution of symptoms usually happens within 6 months.

Test Taking Tip

Mnemonic for Bell’s Palsy: B is for “blinking reflex abnormal”. E is for “earache”. L is from “lacrimation” (deficient or excess). L is for “loss of taste’. S is for “sudden onset”. And P is for “palsy’ of VII nerve muscles.

Video Rationale