Wear an eyepatch over one eye (alternating from side to side) if diplopia
Control factors which lead to fatigue.
(7) Emphasize importance of avoiding contact with individuals with colds or
respiratory infections, since these conditions could be devastating to the myasthenic
(8) Instruct patient to inform dentist of myasthenia condition since
Novocaine is usually poorly tolerated.
Instruct patient to rest at frequent intervals and avoid fatigue.
d. Management of the Crises of Myasthenia.
(1) Myasthenic crisis may result from natural deterioration of the disease,
emotional upset, upper respiratory infection, surgery, or steroid therapy.
(2) Patient may be temporarily resistant to anticholinesterase drugs or need
Cholinergic crisis may result from overmedication with anticholinergic
(4) Patient must be placed in an intensive care unit for continuous
monitoring of the patient's respiratory status.
(5) Provide ventilatory assistance, endotracheal intubation, mechanical
ventilation, if required.
(6) Administer appropriate medications, as determined by patient's status
and cause of the crisis.
(7) Support patient's fluid and nutritional needs, as ordered and indicated by
Give continued psychological support during crisis period, as patient is
Section VII. CRANIAL NERVE DISORDERS
2-37. BELL'S PALSY
a. Definition. Bell's Palsy is a cranial nerve disorder characterized by facial
paralysis. Peripheral involvement of the 7th cranial nerve (facial nerve) produces
weakness or paralysis of the facial muscles. The cause of this condition is unknown,