Bell's palsy

Bell's palsy
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Defi:
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idiopathic
sudden onset
unilateral facial nerve paralysis

typically shows some degree of improval within 4 to 6 months.
If known etiology, or If slowly progressive -> not Bell's palsy

Symp
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Motor: Unilateral paralysis (lower motor neuron involving all branches of facial nerve)
Sensory: Facial pain along the course of the facial nerve
Dry eye

Clinical exam
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ipsilateral conductive loss(sensorineural hearing loss) should be invesitaged for possible middle ear infection/neoplastic lesions

Diff Dx
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Stroke - forehead is spared. other neurological dysfunctions are often present.
Middle ear infection complication
Tumour - ipsilateral hearing loss

mem tip: 스튜오(디스 이름이) Bell.

Rx:
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BMJ BEST PRACTICE -> Predisone 25 mg dly PO for 10 days
UPTODATE -> Prednisone 60 mg dly PO for 7 days + valacyclovir 1g tds PO for 7 days

eye protection - artificial tears, ophthalmic lubricant

Prognosis:
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71 % pts recovers to normal or near normal (24 % recovers to normal)