Chapter

Bell’s Palsy

Selena E. Heman-Ackah

in Neurotology

Published on behalf of Oxford University Press

Published in print October 2014 | ISBN: 9780199843985
Published online November 2014 | e-ISBN: 9780199348992 | DOI: http://dx.doi.org/10.1093/med/9780199843985.003.0023

Series: What Do I Do Now

Bell’s Palsy

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Bell’s palsy or idiopathic facial paresis is a diagnosis of exclusion and is the most common cause of unilateral facial paralysis. The paresis or paralysis evolves over 24–48 hours and is associated with edema of the peripheral facial nerve leading to neuropraxia The etiology of Bell’s palsy is believed to be viral (latent herpes, varicella, upper respiratory). The House-Brackmann facial dysfunction scale is described. There is near normal spontaneous resolution of function in about 85% of patients within few months. A differential for facial paralysis including Lyme disease and Ramsay Hunt syndrome are discussed. Diagnostic evaluation of facial paralysis rarely requires MRI scanning unless the paralysis is recurrent. The management as well as natural history of Bell’s palsy are reviewed. Most often high doses of steroids and antiviral agents are provided as soon as possible and eye protection utilized until resolution. Surgical decompression of the nerve is rarely required.

Chapter.  2342 words. 

Subjects: Neurology

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