Bells Palsy

Question 1

define bells palsy?

Answer 1

acute, unilateral idiopathic lower motor neurone facial nerve palsy

Question 2

what are the risk factors of bells palsy?

Answer 2

• Herpes Simplex Virus might be associated

* 60% are preceded by an upper respiratory tract infection

Question 3

epidemiology of bells palsy?

Answer 3

• Most cases: 20-40 yrs

* More common in pregnant women

Question 4

presenting complaints of bells palsy?

Answer 4

• Preceding pre-auricular pain
• This is followed by unilateral facial weakness and droop
• FOREHEAD IS AFFECTED
• Altered taste
• Dry eyes
• Hyperacusis

Question 5

what are the signs of bells palsy on physical examination?

Answer 5

• affects the forehead
• Eyeball rolls up but the eye remains open when trying to close their eyes
• often testing of sensation is normal
• ears need to be examined for cause

Question 6

investigations for bells palsy

Answer 6

• often unnecessary

Question 7

management plan for bells palsy?

Answer 7

• High-dose corticosteroids given within 72 hrs
• Antivirals to be given for severe facial palsy
• Protection of cornea with artificial tears

Question 8

possible complications for bells palsy?

Answer 8

• Corneal ulcers
• Eye infection
• Aberrant reinnervation

Question 9

prognosis for patients with bells palsy?

Answer 9

• 85-90% recover function within 2-12 weeks with or without treatment