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.
Features
• lower motor neuron facial nerve palsy – forehead affected
• patients may also notice post-auricular pain (may precede paralysis), altered taste, dry eyes
Management
• in the past a variety of treatment options have been proposed including no treatment, prednisolone only and a combination of aciclovir and prednisolone
• following a National Institute for Health randomised controlled trial it is now recommended that prednisolone 25mg bd for 10 days should be prescribed for patients within 72 hours of onset of Bell’s palsy. Adding in aciclovir gives no additional benefit
• eye care is important – prescription of artificial tears and eye lubricants should be considered
Prognosis
• if untreated around 15% of patients have permanent moderate to severe weakness
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