Bell's palsy

Question 1

What is bell’s palsy?

Answer 1

acute, unilateral facial nerve weakness or paralysis of rapid onset and unknown cause

Question 2

Potential contributing factors

Answer 2

HSV, VZV, autoimmunity

Question 3

prevalence

Answer 3

20-30/100 000

15-45 years

Question 4

complications

Answer 4

eye injury 
facial pain 
dry mouth 
intolerance to noises 
psychological sequelae

Question 5

time

Answer 5

less than 72 hours

Question 6

facial weakness

Answer 6

unilateral
upper and lower parts of face
droop eyebrow and corner of mouth
loss of nasolabial fold

Question 7

eyes

Answer 7

incomplete closure

dryness, pain, excess tearing

Question 8

ear

Answer 8

ear and postauricular pain on affected side

Question 9

hyperacusis

Answer 9

increased sensitivities to sound

Question 10

management options

Answer 10

eye drops, taped closed at night
within 72hrs - prednisolone
antiviral+ CCs

Question 11

when to urgently refer?

Answer 11

worse/new neurological findings
features of UMN
features suggesting cancer
trauma
systemic or severe local infection

Question 12

other places to refer

Answer 12

facial nerve specialist
ophthalmologist
counselling