The management of a Bell's Palsy Diagnosis in a Geriatric Patient Following COVID-19 Vaccination

RESEARCH OBJECTIVES: To educate health care professionals about and document the potential unique incidence of Bell's Palsy diagnosis following COVID-19 vaccination during the pandemic while documenting significance of high-volt pulsed electrical stimulation intervention strategies by a physical therapist. DESIGN: Single subject retrospective case study. SETTING: Private practice physical therapy out patient clinic. PARTICIPANTS: Retrospective single subject case study, based on diagnosis. INTERVENTIONS: A 72-year-old female, independent in all activities of daily living, experienced significant symptoms of Bell's Palsy following a COVID-19 vaccine. Past medical history included idiopathic Bell's Palsy on the contralateral side. Functional difficulties were documented and Facial Disability Index scores obtained. Physical therapy was initiated and utilized electrical stimulation protocol, active and active assistive exercise, and patient education/support. Focus for electrical stimulation included Frontalis, Orbicularis Oculi, Zygomaticus Major and Orbicularis Oris. Significant improvement and a full return to function was documented in 7 weeks. MAIN OUTCOME MEASURES: Functional tolerances (patient reported), visual/strength improvements, and Facial Disability Index scores. RESULTS: Patient participation in physical therapy for the treatment of Bell's Palsy following a first dose vaccine for COVIID-19 is documented, with the outcome being full return to function and all social activities. FDI scores improved significantly as well as patient satisfaction scales, and the patient reported full credit to the physical therapy for the recovery, while refusing other interventions that were offered. CONCLUSIONS: This case study presents a unique onset and etiology for a Bell's Palsy in a geriatric patient and contributes to the literature by offering physical therapy interventions with outcome findings. Patient advocacy for obtaining physical therapy was critical and significantly meaningful. Given the unique case of a single subject control, this case may be valuable for clinicians who may be presented with cases in the clinic, or for educational purposes in the classroom. AUTHOR(S) DISCLOSURES: None.