Bell (facial nerve) palsy

Question 1

Pharmacological Rx

Answer 1

Prednisolone 1 mg/kg (o) (usually 60 mg) daily in the morning for 5 d, then taper to zero over next 7 d (start within 48 h of onset).

Evidence unconvincing for this and also aciclovir but considered applicable for more severe cases.

Use aciclovir for Ramsay–Hunt syndrome

Question 2

General measures

Answer 2

Patient education and reassurance

Adhesive tape or patch at night over eye if corneal exposure

Artificial tears if eye dry, esp. at night

Massage and facial exercises during recovery

About 80% spontaneous recovery, especially if mild