Bells Palsy

Question 1

Definition

Answer 1

An acute, unilateral facial nerve weakness of less than 72 hours onset and unknown cause

Question 2

Prevalance

Answer 2

Relatively uncommon, affects men and women equally in ages 15-45

Question 3

Risk Factors (6)

Answer 3

diabetes
obesity
HTN
Upper resp infections
pregnancy
immunocompromised

Question 4

Presentation (7)

Answer 4

Facial muscle weakness NOT forehead sparing
ear pain
dry mouth
change to taste
numbness
drooling
Abnormal cranial nerve exam

Question 5

Cause

Answer 5

May be due to inflammation of facial nerve causing compression of nerve through the temporal bone

Question 6

Management (2)

Answer 6

Prednisolone 50mg daily for 10 days or 60mg daily for 5 days

Advise about eye care (keeping it lubricated and avoid irritation) and eating

Question 7

Complications

Answer 7

Eye injury
vision loss
facial pain
dry mouth,
intolerance to loud noises, synkinesis (abnormal facial muscle contraction)

Question 8

Differentials (7)

Answer 8

Stroke

Brain tumour

Traumatic injury to facial nerve

Skin cancer

Infections – herpes simplex, Lyme diseases, otitis media, cholesteatoma, encephalitits

Diabetes

MS