🔺CASE STUDY: NO 42 🔺 PART NO : 1 🔺 ARDITA (BELL'S PALSY) 🔺 Nidanam (Etiology/Causative Factors) of Ardita -Vata prakopaka hetus: -Exposure to cold wind -Suppression of natural urges -Excessive talking, shouting -Injury to the nerves or trauma to the face/head -Emotional stress References: Charaka Samhita Chikitsa Sthana 28/41, Sushruta Samhita Nidana Sthana 1/64 🔺 Purvaroopam (Prodromal Symptoms) -Mild tingling or numbness of one side of the face -Slight drooping of the mouth or eyelid -Difficulty in speech or articulation -Stiffness or discomfort in the jaw/neck region(Reference: Ashtanga Hridaya Nidana Sthana 15/6) 🔺 Lakshanam (Symptoms/Clinical Features) -Sudden deviation or distortion of one side of the face -Inability to close one eye or move facial muscles on the affected side -Difficulty in speech, chewing, or blowing -Loss of facial expressions on the affected side -Often unilateral (ardha-mukha vikara)References:Charaka Samhita Chikitsa Sthana 28/41-42,Ashtanga Hridaya Nidana Sthana 15/4 🔺 SYSTEMIC EXAMINATION 📌 General Examination -Facial asymmetry at rest and during movement (e.g., smiling, eye closure) -Deviation of mouth to unaffected side -Incomplete closure of the eye (lagophthalmos) -Drooling from affected side -Loss of nasolabial fold -Inability to puff cheeks or raise eyebrows (LMN type) Neurological Examination -Cranial Nerve VII (Facial Nerve): Weakness of facial muscles on one side (LMN lesion) -Taste sensation loss (anterior 2/3 of tongue) -Hyperacusis (if stapedius affected) -Assessment of corneal reflex (afferent V, efferent VII) -Rule out other cranial nerve involvement (to assess for brainstem lesion) ENT Examination -Otoscopy to rule out otitis media, cholesteatoma, or herpes zoster oticus (Ramsay Hunt Syndrome) 🔺 LAB INVESTIGATIONS Routine Tests -CBC, ESR: Rule out systemic infection/inflammation -Blood sugar (FBS, PPBS): To rule out diabetic neuropathy -Serum B12 and folate levels Specific Investigations -MRI Brain + Internal Acoustic Meatus: -Rule out stroke, multiple sclerosis, acoustic neuroma, tumors -CT Temporal Bone: If trauma or fracture suspected Electroneurography (ENoG) or Electromyography (EMG): -Assess degree of nerve damage and prognosis Viral markers: -HSV, VZV if viral etiology suspected (Ramsay Hunt Syndrome) -Lyme serology: In endemic areas 🛑https://chat.whatsapp.com/JtHGdxv7A5SA9bAe8ZNIS2