Bell Palsy Flashcards
1
Q
What is Bell Palsy?
A
- Most common acute mono-neuropathy, or disorder affecting a single nerve
- Most common Dx associated with facial nerve paresis or paralysis of unknown cause
- Causes partial or complete inability to voluntarily move facial muscles on the affected side of the face
2
Q
What does facial paresis/paralysis cause?
A
- Significant oral incompetence
- Eye injury
- Long term poor outcomes can occur
3
Q
How is Bell Palsy diagnosed?
A
- Dx of exclusion
- Dx when no other medical etiology is identified as a cause of facial weakness
- Not every pt with facial paralysis/paresis will have Bell palsy
4
Q
How is Bell Palsy treated?
A
- Variations in care
- Controversy over best treatment options
5
Q
What are the characteristics of Bell palsy?
A
- Rapid in onset (<72 hrs)
- Unilateral more common than bilateral
- Cause is unknown
- Most common in 15-45 y/o
6
Q
What are the risk factors for Bell Palsy?
A
- Pregnancy
- Severe preeclampsia
- Obesity
- Hypertension and chronic hypertension
- Diabetes
- Upper respiratory ailments
7
Q
What is the prognosis for Bell palsy?
A
Majority have spontaneous, good recovery at 3-6 months
8
Q
When does Bell palsy have the best prognosis?
A
- Never at grade VI
- Signs of recovery at 2 mos
- EMG evidence of voluntary activity
- Present AR
- <90% degeneration of ENoG at 2 week point
9
Q
When does Bell palsy have the worst prognosis?
A
- Age >65 years
- Diabetes
- > 90% degeneration of ENoG at 2-week point
10
Q
How is Bell palsy treated?
A
Steroid Rx- should be given in 72 hrs for >16 y/o
Antiviral therapy used in combination with oral steroid by some
11
Q
What are the surgical treatment options for Bell palsy?
A
Facial nerve decompression
- Transmastoid
- Middle cranial fossa decompression
*No clear evidence of efficacy
