The Colombian Physiotherapist Association is searching a lecturer for its
National Congress to be held in 08-2000 in Bogotá.
He/She must be qualified in stroke rehabilitation.
Elsa Colmenares
At 07:06 AM 18/02/1999 -0500, you wrote:
>Bell's Palsy has several different mechanisms through which it occurs. In
>this patient's case, apparently the axon was damaged and when the muscles
>reinnervated, a motor unit that only innervated a "chewing" muscle (I imagine
>the massetor or obicularis oris) now has muscle fiber which go to her
>obicularis
>occuli. The "all or none" firing pattern in a motor unit would mean that
>there
>is no way for a person to independently fire only the part of the motor
>unit that
>goes to one area and not fire the other. BUT, I worked with a patient that
>had
>a similar problem after a surgery which "hooked" the 7th cranial nerve to
>the 12th
>(if my memory and anatomy serve me correctly) after Bell's Palsy that did
>not resolve
>and she developed a similar dsykinesia as the muscles reinnervated. she was
>able
>to successfully retrain her muscles reasonably well. The problem is
>not stimulating the muscles to fire but retraining. So the modality to use
>would be biofeedback muscle reeducation, if correction is possible. A mirror
>works well! as does the hand on the eye trying to "slowly" isolate the mouth
>muscles while not firing the muscles around the eye. Patient education is
>all that I would use with 2 or 3 sessions to determine if she can
>successfully isolate
>the movement. Good Luck! A very interesting problem.
>
>At 10:26 AM 2/18/99 GMT, you wrote:
>>
>>Hello everyone
>>Can anyone advise me about a patient who had Bell's palsy - onset last
>>May? I haven't yet seen her but she rang me for advice and I don't wish
>>to waste her time.
>>She says she has made a good recovery but still has a problem with her
>>eye which tends to close when she chews or whistles. I don't know
>>whether one of those trophic facial stimulators would be appropriate for
>>her to use at this time or not? If so, is there anywhere in the UK where
>>she can hire one since they seem to be pretty expensive. I said I'd ask
>>you guys out there - would be grateful for your help.
>>Thanks all for your further help with Generation II braces!
>>Sophie
>>
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>____________________________________________________________________________
>___
>Herb Silver
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>
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