Topic 1

bell’s palsy

100

True or False: Bell's palsy is sudden-onset, unilateral (one-sided), peripheral facial nerve (CN VI) paralysis

FALSE 

Bell's palsy is sudden-onset, unilateral (one-sided), peripheral facial nerve (CN VII) paralysis

200

what is the epidemiology of bell’s palsy in australia

The annual incidence is estimated to be 11–40 per 100,000, with a lifetime risk of one in 60.

300

what’s the most common cause of Bell’s palsy 

it’s idiopathic

400

name three risk factors for bell’s palsy 

1. reactivation of latent herpes simplex virus type 1 (HSV-1)

2. pregnancy

3. diabetes

4. hypertension

5. obesity

5. recent viral infection

6. upper respiratory infection 

7. family history of bell’s palsy 

8. immunosuppresion

500

what is the clinical differentiation between bell’s palsy and a stroke and why 

bell’s palsy - whole face including forehead while stroke - lower face, forehead spared, because its upper motor neuron 

stroke

100

what does FAST stand for 

Face, Arms, Speech, and Time

200

how many strokes occur a day in australia in 2023

113

300

name 3 risk factors for stroke

Atrial fibrillation, high blood pressure, lifestyle factors - obesity, males

400

what is the different nerve lesion in a stroke vs bell’s palsy

bell’s palsy - lower motor neuron CN XII 

stroke - upper motor neuron corticobulbar lesion 

500

what are the three types of stroke

Ischemic stroke, Hemorrhagic stroke, Transient ischemic attack

Ischemic stroke  a blood vessel supplying the brain is blocked, usually by a thrombus or an embolus 

Hemorrhagic stroke: a blood vessel ruptures and bleeds into the brain. Two subtypes: intracerebral hemorrhage (bleeding into brain tissue) and subarachnoid hemorrhage (bleeding into the space around the brain, often from an aneurysm rupture). 

Transient ischemic attack (TIA): transient neurological dysfunction from focal ischaemia, typically lasting under an hour, without infarction. Often a warning sign of future stroke

upper and lower motor neuron lesions

100

what is an upper motor neuron  

the UMN pathway carries motor information from the brain to the motor nuclei of the brainstem or spinal cord 

200

what is a lower motor neuron 

LMN is the final pathway from the CNS to the muscle

300

name 3 typical signs for UMN lesion 

weakness, spasticity, hyperreflexia, clonus, babinski sign (+ve), increased tone 

400

name 3 LMN lesion signs

hyporeflexia, marked wasting (muscle wasting), hypotonia, weakness, paralysis

500

List 3 risk factors for UMN/LMN lesions 

• Stroke 
• Spinal cord injury
• Multiple sclerosis
• Cerebral palsy 
• Malignancy
• Infections (brain abscess, myelitis)
• Inflammatory, neurodegenerative, and metabolic  disorders 
• Primary lateral sclerosis and hereditary spastic paraplegia, the pure-UMN motor neuron diseases

fun facts

100

can bell’s palsy affect more than facial movement, and if so why?

yes, CN VII is not purely motor, it can affect special sensory —> anterior 2/3 of tongue and parasympathetic —> lacrimal and salivary glands

200

where did the name Bell’s palsy come from

Bell's palsy is named after Sir Charles Bell, a 19th-century Scottish surgeon and anatomist who first described the connection between the facial nerve and facial paralysis

300

Who is driving to the airport twice this holiday 

Elisha 

400

When is HP part 1 due 

Today 2355

500

how many more ICLs is Lachie attending

TBC