Peripheral facial palsy

Developing of a speech therapy protocol assessment for clinical following, presentation of clinical evolution of two cases

Abstract

Peripheral facial palsy (PFP) or bell palsy, implies lost or degree of facial movements by facial nerve illness.  Annual incidence is between 30 and 40 every 100.000 people. Traditional Treatment methods are mostly pharmacologic and motor rehabilitation. Patients often have issues to chew, speak, swallow, and express emotions.  Traditional Facial palsy grading and assessment methods are based on subjective judgment or medical criteria.  Consequently, it arises the need to develope a simple, quantitative, and organized method to get  graduation and clinical accuration of the patient's evolution during the treatment. A speech therapy protocol assessment for peripheral facial palsy (STPAPFP) was developed with three domains: resting asymmetries, contraction in muscular synergies, and stomatognathic functions.

Evolution of two patients is presented: a 56-year- old masculine (A), and a 44-year-old female (B), with idiopathic PFP diagnosis, who came to Speech Therapy service in “Hospital Nacional de Clínicas”.  Manual neuro-motor activation therapy was applied periodically and they were graded in three stages: at the begining, in the meanwhile and at present. 

In both cases, STPAPFP enabled/allowed to set the degree of PFP severity and characterization on the three domains, yielding quantitative and concordant results between degree and stage: At the begining: severe (patient scores A: 71; B: 83); in the meanwhile: moderate (A: 39; B: 51) and at present: mild (A: 23; B:18).

Application of STPAPFP yields clinical and functional relevant data in each domain that allowed a precise speech therapy diagnosis, rehabilitation according to plan and severity grade determination of PFP in three stages. The STPAPFP made possible the following of A and B cases during therapy, using an organized, quick, cheap and quantitative assessment. The application of STAPAPFP in a larger sample is expected a check to verify its reliability and posterior validation as a speech therapy clinical assessment instrument.