Presentation: Ear Ache Flashcards
What is Bell’s palsy?
Bell’s palsy may be defined as an acute, unilateral, idiopathic, facial nerve paralysis.
What is the aetiology of Bell’s palsy?
The aetiology is unknown although the role of the herpes simplex virus has been investigated.
What is the peak incidence age range for Bell’s palsy?
The peak incidence is 20-40 years.
Who is more commonly affected by Bell’s palsy?
The condition is more common in pregnant women.
What are the features of Bell’s palsy?
Lower motor neuron facial nerve palsy affects the forehead. Patients may also notice post-auricular pain, altered taste, dry eyes, and hyperacusis.
What is the management consensus for Bell’s palsy?
All patients should receive oral prednisolone within 72 hours of onset.
What is the recommendation regarding antiviral medications for Bell’s palsy?
Antiviral treatments alone are not recommended, but UpToDate suggests adding antivirals for severe facial palsy.
What eye care measures should be taken for Bell’s palsy patients?
Eye care is important to prevent exposure keratopathy. Prescription of artificial tears and eye lubricants should be considered. If unable to close the eye at bedtime, they should tape it closed using microporous tape.
What should be done if there is no improvement in paralysis after 3 weeks?
Refer urgently to ENT.
When might a referral to plastic surgery be appropriate for Bell’s palsy patients?
A referral may be appropriate for patients with more long-standing weakness, e.g., several months.
What is the prognosis for most people with Bell’s palsy?
Most people make a full recovery within 3-4 months.
What percentage of untreated patients may have permanent weakness from Bell’s palsy?
Around 15% of untreated patients have permanent moderate to severe weakness.
