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Bell Palsy

Reviewed 06/2020
 


BASICS

DESCRIPTION

An acute, usually unilateral, peripheral facial nerve palsy of unknown etiology. Herpes-mediated viral inflammatory/immune mechanism is the likely cause of most cases, causing subseq...

DIAGNOSIS

HISTORY

  • Time course of the illness: rapid onset (over 24–48 hours) of sudden and progressive unilateral lower motor neuron-type facial weakness

  • Peak of symptoms occur within 48–72 hours

  • Predisp...

TREATMENT

GENERAL MEASURES

  • Artificial tears should be used to lubricate the cornea

  • The ipsilateral eye should be patched and taped shut at night to avoid drying and infection

MEDICATION

  • Corticosteroids de...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Patients should start steroid treatment immediately and be followed for 12 months.

  • Patients who do not recover complete facial nerve function sho...

REFERENCES

1
Hohman MH, Hadlock TA. Etiology, diagnosis, and management of facial palsy: 2000 patients at a facial nerve center. Laryngoscope.  2014;124(7):E283–E293.
2
Baugh RF, Basura GJ, Ishii LE...

ADDITIONAL READING

SEE ALSO

Amyloidosis; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Herpes Simplex; Herpes Zoster (Shingles); Lyme Disease; Sarcoidosis; Sjögren Syndrome 

CODES

ICD10

G51.0 Bell’s palsy 

ICD9

351.0 Bell’s palsy 

SNOMED

  • 193093009 Bell’s palsy (disorder)

  • 12239621000119103 Bells palsy of left side of face (disorder)

  • 12239661000119108 Bells palsy of right side of ...

CLINICAL PEARLS

  • Look closely at the voluntary movement on the upper part of the face on the affected side; in Bell palsy, all of the muscles are involved (weak or paralyzed), whereas in a stroke, the ...

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