Facial Palsy in Neonates - BSc Nursing - Garden City University College

GARDEN CITY UNIVERSITY COLLEGE-GCUC BSc NURSING –LEVEL 300A PEDIATRIC`S GROUP PRESENTATION GROUP THREE PRESENTING ON- FACIAL PALSY IN NEONATES OBJECTIVES  Introduction  Causes  Clinical manifestation  Diagnostic investigation  Medical management/Surgical management...

GARDEN CITY UNIVERSITY COLLEGE-GCUC BSc NURSING –LEVEL 300A PEDIATRIC`S GROUP PRESENTATION GROUP THREE PRESENTING ON- FACIAL PALSY IN NEONATES OBJECTIVES  Introduction  Causes  Clinical manifestation  Diagnostic investigation  Medical management/Surgical management  Nursing management  Prevention INTRODUCTION/DEFINITON Facial palsy in neonates, also known as facial nerve palsy, refers to the loss of voluntary muscle movement in an infant’s face. This condition can occur due to various reasons, including birth trauma, where pressure on the facial nerve just before or during birth leads to the condition.  CAUSES/RISK FACTORS  Birth Trauma: Pressure on the facial nerve during delivery, especially in difficult or prolonged labor, can lead to facial palsy.  Congenital Conditions: Some babies are born with facial nerve palsy due to developmental issues in the womb.  Infections: Viral infections, such as Bell’s palsy, can cause inflammation and damage to the facial nerve.  Forceps Delivery: The use of forceps during delivery can sometimes put pressure on the facial nerve.  Maternal Health Conditions: Certain maternal health issues, like diabetes, can increase the risk of neonatal facial palsy.  Genetic Factors: Rare genetic disorders can also lead to facial nerve palsy in newborns. CLINICAL FEATURES/MANIFESTATIONS Facial Asymmetry: One side of the face may appear droopy or less expressive than the other. Difficulty Closing One Eye: The affected eye may not close completely, leading to dryness and irritation. Asymmetrical Smile: When the baby cries or smiles, one side of the mouth may not move as much as the other. Drooling: Due to difficulty controlling facial muscles, the baby may drool more than usual. Feeding Challenges: Problems with sucking and swallowing can occur, making feeding difficult. Lack of Movement: Reduced or absent movement in the muscles on one side of the face.  DIAGNOSIS/INVESTIGATIONS Physical Examination: A thorough physical exam is usually the first step. The healthcare provider will assess the baby’s facial movements and symmetry. Medical History: Gathering information about the pregnancy, delivery, and any family history of similar conditions. Electrodiagnostic Tests: Nerve conduction studies or electromyography (EMG) can help pinpoint the location and extent of nerve damage. Imaging Studies: MRI (Magnetic Resonance Imaging): Useful for visualizing the facial nerve and identifying any structural anomalies. CT (Computed Tomography) Scans: Can help detect bone abnormalities or other structural issues. Blood Tests: To rule out infections or other systemic conditions that might contribute to facial palsy. Specialized Tests: In some cases, additional tests like video recordings of facial movements may be used to  MEDICAL MANAGEMENT corticosteroid[e.g. prednisone or dexamethasone]to reduce inflammation Antiviral medication[if infectious causes suspected]e.g. Acyclovir Antibiotics e.g. Ampicillin, Gentamicin or ceftriaxone Eye drop or ointments to prevent dryness of the eye  SURGICAL MANAGEMENT Nerve Decompression: This procedure involves relieving pressure on the facial nerve, which can help restore function if the nerve is compressed. Nerve Grafting: In cases where the facial nerve is severely damaged, a nerve graft from another part of the body may be used to repair the damaged nerve. Muscle Transfer: If the facial muscles are not functioning, a muscle transfer procedure can be performed. This involves transferring a muscle from another part of the body to the face to restore movement. Botulinum Toxin Injections: While not a surgical procedure, Botulinum toxin (Botox) injections can be used to manage muscle imbalances and improve facial symmetry.  NURSING MANAGEMENT Feeding Assistance: Babies with facial palsy may have difficulty sucking and swallowing. Nurses can provide guidance on using special feeding techniques and tools, such as: Special Bottles: Designed to make sucking easier. Nipple Shields: Help the baby latch onto the breast more effectively. Feeding Tubes: For severe cases where oral feeding is not possible. Eye Care: If the baby cannot close one eye completely, it’s crucial to protect the eye from dryness and injury. Nurses may use lubricating eye drops or ointments and ensure the eye is covered with a protective patch when necessary. Physical Therapy: Nurses can teach parents gentle facial exercises to help improve muscle strength and coordination. Consistent practice of these exercises can aid in recovery. Monitoring and Support: Regular monitoring of the baby’s progress is essential. Nurses provide emotional support to parents, educate them about the condition, and ensure they understand the importance of follow-up appointments.  Cond`t Infection Prevention: Maintaining good hygiene and monitoring for signs of infection is important, especially if there are any open areas or if the baby has undergone surgery. Parental Education: Educating parents about the condition, its potential causes, and the expected course of recovery helps them feel more confident in managing their baby’s care. Supportive Care: Ensuring the baby is feeding well and maintaining good nutrition is crucial. Special feeding techniques or devices may be recommended if feeding difficulties are present  PREVENTION Prenatal Care: Regular Check-ups: Ensuring regular prenatal visits to monitor the health of both the mother and the baby. Managing Maternal Health: Controlling conditions like diabetes and hypertension that can increase the risk of complications during delivery. Safe Delivery Practices: Avoiding Prolonged Labor: Monitoring labor progress to avoid prolonged or difficult labor, which can increase the risk of birth trauma. Careful Use of Instruments: If instrumental delivery (e.g., forceps or vacuum) is necessary, ensuring it is performed by experienced healthcare providers to minimize the risk of nerve damage. .  Cond`t Education and Training: Healthcare Provider Training: Ensuring that healthcare providers are well-trained in safe delivery techniques and the management of high-risk pregnancies. Parental Education: Educating expectant parents about the signs of facial palsy and the importance of seeking prompt medical attention if they notice any symptoms. Monitoring and Early Intervention: Early Detection: Promptly identifying and addressing any signs of facial palsy in newborns to initiate appropriate management and support recovery NAMES INDEX NUMBES AMADU NAFISA 03110286222 ADAMA USMAN 0311031722 DANEKU FRANK 0311043622 OWUSU APPIAH EDWARD 0311005122 VERA SARFO 0311032422 PAINTSIL KOBINA KUSI 0311048922 OPOKU-AGYEI MICHAEL 0311039522 DWOMOH JESSICA BIRAGO 0311037722 ASAMOAH GLORIA 0311016222 SANI RAFIATU 0311033422 OFORI DAVID 0311014722 EMMANUELLA AYERE 0311046122