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Bell’s palsy: Acute idiopathic unilateral paralysis of the facial nerve.
Etiology is most commonly vascular, inflammatory or viral. Risk factors include pregnancy, obesity, hypertension and diabetes
- Drooping of the eyelid or an inability to completely close the eye
- Drooping of the corner of the mouth
- Unable to raise an eyebrow or wrinkle the forehead
Additional symptoms (related to facial nerve function)
- Dry eye with epiphora (excessive tearing)
- Ipsilateral loss of taste sensation
- Central Lesion of the facial nucleus of the brain stem, UMNL (Lower motor neuron – forehead is involved)
- Ramsy Hunt syndrome (Herpes Zoster oticus), painful rash in ear
- Ramsay-Hunt syndrome
- Parotid tumour
- Malignant otitis externa
- Otitis media
- Lyme disease
- Guillain-Barre syndrome
- Note: Can present as a polyneuritis involving trigeminal, glossopharyngeal, 2nd cervical or vagal nerve.
Course and treatment
- Usually self-limiting and resolves after 12 weeks.
- Steroids help in severe cases (early complete paralysis) improves recovery time.
- Most important supportive treatment is eye protection!