Patient Information – Case Study
Monika
45 Years Old | Female
Presenting Complaints
- Difficulty in performing facial expressions
- Deviation of the face towards the right side
- Pain behind the ear during acute phase
Medical Diagnosis
- Herpes zoster–induced Bell's palsy
Mechanism / Onset
- Reactivation of herpes zoster virus affecting the facial nerve, leading to acute lower motor neuron facial palsy.
Medical Management
- Medical management for herpes zoster and facial nerve involvement as advised by the treating physician.
Assessment & Clinical Challenges
Clinical Findings
- Facial Symmetry: Marked facial asymmetry with deviation on the right side
- Motor Function: Reduced voluntary control of facial muscles
- Pain: Pain present behind the ear during the acute phase
- Functional Limitation: Difficulty in facial expressions such as smiling, eye closure, and lip movements
Physiotherapy Intervention Plan
Electrical Stimulation
- Electrical stimulation to facilitate facial muscle activation
Facial Exercises
- Facial exercises to improve muscle control and symmetry
Class IV Laser Therapy
- Class IV laser therapy for pain relief and nerve healing
Soft Tissue Therapy
- Soft tissue massage to improve circulation and reduce muscle stiffness
Result Outcomes
Significant improvement in all facial expressions
Restoration of facial symmetry with no residual deviation
Complete resolution of pain
Clinical Conclusion
This case highlights the effectiveness of a comprehensive physiotherapy approach in managing Herpes zoster–induced Bell’s palsy. The combination of electrical stimulation, targeted exercises, laser therapy, and soft tissue techniques resulted in complete recovery of facial symmetry and function. Early intervention and consistent therapy were key factors in achieving these excellent outcomes. The patient’s commitment to the home exercise program also played a crucial role in her recovery.