Bells palsy

Question 1

What is a bells palsy?

• who is affected
• peak incidence

Answer 1

Bell’s palsy may be defined as an acute, unilateral, idiopathic, facial nerve paralysis. The aetiology is unknown although the role of the herpes simplex virus has been investigated previously. The peak incidence is 20-40 years and the condition is more common in pregnant women.

Question 2

What is the clinical features of a bells palsy?

Answer 2

Lower motor neuron facial nerve palsy - forehead affected* (in upper motor neuron lesions e.g. stroke, forehead is spared)
patients may also notice post-auricular pain (may precede paralysis), altered taste, dry eyes, hyperacusis

Question 3

What is the treatment?

Answer 3

prednisolone 1mg/kg for 10 days should be prescribed for patients within 72 hours of onset of Bell’s palsy.
-eye care: lubricant/artificial tears

Question 4

what is the prognosis?

Answer 4

if untreated around 15% of patients have permanent moderate to severe weakness