Bell's Palsy

Question 1

What is Bell’s Palsy?

Answer 1

Idiopathic facial nerve palsy

Question 2

How does Bell’s palsy present?

Answer 2

abrupt onset e.g. overnight, after a nap
complete unilateral facial weakness at 24-72hrs
ipsilateral numbness/pain around ear
ageusia (loss of taste)

Question 3

How is Bell’s palsy diagnosed?

Answer 3

A diagnosis of exclusion (e.g. exclude Lyme disease, Rasmay hunt, SOL, stroke, MS)
Test CN VII (puff out cheeks, scrunch up eyes, raise eyebrows)

Question 4

How is Lyme disease ruled out?

Answer 4

test for Borrelia antibodies

Question 5

How is Ramsay Hunt ruled out?

Answer 5

VZV antibodies

Question 6

What is the treatment of Bell’s Palsy?

Answer 6

if within 72hrs of symptoms - prednisolone

protect eye - dark glasses, drops, tape closed at night