[bells palsy] Flashcards Preview

NEUROLOGY > [bells palsy] > Flashcards

Flashcards in [bells palsy] Deck (21)
1

[bells]: what % of VII nerve palsys are Bells?

70%

2

[bells]: duration of onset is always ...

rapid (e.g. overnight/after a nap)

3

[bells]: what is the pattern of facial weakness

unilateral weakness

4

[bells]: why might there be hypersensitivity to sounds

hyperacusus (stapedius)

5

[bells]: what 2 sensory signs might there be and where

Pain (ear)
sensory loss (ipsilateral)

6

[bells]: why might there be reduced taste

VII supplies anterior 2/3s of the tongue

7

[bells]: what are the 2 major risk factors

DM (500%)
Pregnancy (300%)

8

[bells]: what muscle is used to puff out the cheeks

buccinator

9

[bells]: describe what happens in a VII nerve grimace

normal side pulls lips up, affected side droops. Any 7th nerve palsy

10

[bells]: why is forehead wrinkling spared in UMNL

under bilateral cortical control

11

[bells]: what causes 'crocodile tears'

misconnection of healing paraasympathetic fibres
eating stimulates ipsilateral lacrimation but not salivation

12

[bells]: what infectious disease is indistinguishable from Bells palsy

Borrelia causing Lyme disease

13

[bells]: what Ix would you carry out to check for Lyme disease?

Borrelia antibodies

14

[bells]: 1st line Mx?

prednisolone 60mg/5day

15

[bells]: why do you give artificial tears?

inability to lacrimate

16

[bells][ramsayhunt]: what is the causative agent

varicella zoster virus

17

[bells][ramsayhunt]: which ganglion is affected?

geniculate ganglion of VIIth

18

[bells][ramsayhunt]: what is the cardinal symptom

painful rash in auditory canal

19

[bells][ramsayhunt]: what other symptoms accompany the cardinal (5)

ipsilateral facial palsy
tinnitus
loss of taste
dry mouth/eyes
deafness

20

[bells][ramsayhunt]: 1st line Mx? (2)

Aciclovir 800mg PO 5 times daily for 7 days
+
Prednisolone

21

[bells][ramsayhunt]: within what time period should you aim to administer Tx

72 hours