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__NOTOC__
{{Infobox_Disease
{{Infobox_Disease
  | Name          = Bell's palsy
  | Name          = Bell's palsy
  | Image          = Gray781.png  
  | Image          = Gray781.png  
  | Caption        =  
  | Caption        =  
| DiseasesDB    = 1303
 
| ICD10          = {{ICD10|G|51|0|g|50}}
| ICD9          = {{ICD9|351.0}}
| ICDO          =
| OMIM          =
| MedlinePlus    = 000773
| eMedicineSubj  =
| eMedicineTopic =
| eMedicine_plus =
| MeshID        = D020330
}}
}}
{{Bell's palsy}}
{{Bell's palsy}}
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'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


'''Editor-in-Chief:''' Gilbert Abou Dagher, M.D.
{{CMG}}; {{AE}}{{M.B}} ,{{MMJ}} {{NE}}


{{SK}} Idiopathic facial paralysis,Idiopathic facial nerve paresis,Facial nerve disorder
==[[Bell's palsy overview|Overview]]==
==[[Bell's palsy overview|Overview]]==


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==[[Bell's palsy causes|Causes]]==  
==[[Bell's palsy causes|Causes]]==  


==[[Bell's palsy differential diagnosis|Differentiating Bell's palsy from other Diseases]]==
==[[Bell's palsy differential diagnosis|Differentiating Bell's Palsy from other Diseases]]==


==[[Bell's palsy epidemiology and demographics|Epidemiology and Demographics]]==
==[[Bell's palsy epidemiology and demographics|Epidemiology and Demographics]]==
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==Diagnosis==
==Diagnosis==
[[Bell's palsy history and symptoms|History and Symptoms]] | [[Bell's palsy physical examination|Physical Examination]] | [[Bell's palsy laboratory findings|Laboratory Findings]] | [[Bell's palsy CT|CT]] | [[Bell's palsy MRI|MRI]] | [[Bell's palsy other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
[[Bell's palsy medical therapy|Medical Therapy]] | [[Bell's palsy surgery|Surgery]] | [[Bell's palsy primary prevention|Primary Prevention]] | [[Bell's palsy secondary prevention|Secondary Prevention]] | [[Bell's palsy cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Bell's palsy future or investigational therapies|Future or Investigational Therapies]]
== Case Studies ==
[[Bell's palsy case study one|Case #1]]


[[Bell's palsy medical therapy|Medical Therapy]]
==Related Chapters==
 
*[[Central facial palsy]]
== History and Symptoms ==
 
Sudden onset, usually over hours, of unilateral facial paralysis(maximal symptoms by 48 hours)
 
:*Eyebrow sagging with inability to close the affected eye
:*Nasolabial fold flattening with mouth drawn to the non affected side
:*Inability to wrinkle forehead (peripheral lesion)
:*May be associated with ear pain, impaired taste sensation on the anterior two-thirds of the tongue, decreased tearing, and hyperacusis
 
==Diagnostic Tests==
 
:*Electrodiagnostic studies help determine the prognosis, and imaging studies can define potential surgical causes of facial palsy.
:*These tests are not necessary in all patients.
:*Patients with a typical lesion that is incomplete and recovers do not need further study.
:*Electrodiagnostic studies (EMG, or motor nerve conduction study) and Imaging (CT, or MRI) are needed if the physical signs are atypical, there is slow progression beyond three weeks, or if there is no improvement at six months.
:*Screening blood studies for an underlying systemic disease or infection may also be considered in these cases.
:*There is no test that provides prognostic information early enough to be used for guiding treatment or prognosis.
 
== Risk Stratification and Prognosis==
 
:*The House-Brackmann grading system was devised both as a clinical indicator of severity and also an objective record of progress.
:*Clinically incomplete lesions tend to recover.
:*The natural history without treatment was described in a study of 1011 patients in 1982:
::*67% had incomplete paralysis, with 94% rate of return to normal function
::*33% had complete paralysis, with 60% rate of return to normal function
::*By 3 weeks, 71% had complete recovery, 13% had slight sequelae , and 16% had residual weakness
:*Herpes zoster is associated with more severe paresis and worse prognosis compared with "idiopathic" Bell's palsy.
:*There is a favorable prognosis if some recovery is seen within the first 21 days of onset.
:*In severe lesions that recover, the outgrowth of new axons from the injury site may be disorganized and misdirected.
:*On blinking there is twitching of the angle of the mouth, and on smiling the eye may close or wink.
:*With misdirected autonomic fibers, a salivary stimulus may result in excess lacrimation, the syndrome of "crocodile tears."
:*Recurrent attacks of on either the ipsilateral or contralateral side have been observed in 7 to 15% of patients.
 
==References==
{{reflist|2}}
 
==Additional Resources==
* Sullivan FM, Swan IRC, Donnan PT, et al. Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med 2007;357:1598-1607.
* "The Merck Manual"
* ''New England Journal of Medicine'', Sept. 2004
*  Lambert, Michael. (2007-03-05) [http://www.emedicine.com/emerg/topic56.htm "Bell's Palsy."] (Website.) ''Emedicine''. Retrieved on 2007-09-27.
 
==External links==
*[http://www.facialparalysisinstitute.com managment and treatment of facial paralysis]
*[http://www.bellspalsy.ws/ Bell's Palsy Information Site], has a FAQ
*[http://pregnancyandbaby.com/read/articles/5398.htm Bell's Palsy and Pregnancy]
*[http://www.neurologychannel.com/bellspalsy/ Bell's Palsy Patient Info - Neurology Channel]
*[http://www.facial-palsy.com/ Living with Facial Palsy], a site for parents of children with Facial Palsy
*[http://www.lib.uiowa.edu/hardin/md/bellspalsy.html Links to pictures of Bells palsy (Hardin MD/Univ of Iowa)]
*[http://www.bellspalsy.org.uk/ Bell's Palsy Association]
 


{{PNS diseases of the nervous system}}
{{PNS diseases of the nervous system}}
[[Category:Neurological disorders]]
[[Category:Otolaryngology]]
[[Category: Neurology]]
[[Category: Mature chapter]]
[[ar:شلل العصب الوجهي]]
[[ca:Paràlisi de Bell]]
[[ca:Paràlisi de Bell]]
[[de:Fazialislähmung]]
[[de:Fazialislähmung]]
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{{WH}}
{{WH}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}
[[Category:Neurological disorders]]
[[Category:Otolaryngology]]
[[Category:Neurology]]
[[Category:Disease]]

Latest revision as of 20:36, 29 July 2020

Bell's palsy

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Overview

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Pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohsen Basiri M.D. ,Mohamadmostafa Jahansouz M.D.[2] Niloofarsadaat Eshaghhosseiny, MD[3]

Synonyms and keywords: Idiopathic facial paralysis,Idiopathic facial nerve paresis,Facial nerve disorder

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Bell's Palsy from other Diseases

Epidemiology and Demographics

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | CT | MRI | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

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