Bell's palsy natural history, complications and prognosis: Difference between revisions
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===Natural History=== | ===Natural History=== | ||
*The onset of Bell's palsy is sudden and symptoms typically peak fast, within a few days | *The onset of Bell's palsy is sudden and symptoms typically peak fast, within a few days and include:<ref name="pmid21847333">{{cite journal| author=Murthy JM, Saxena AB| title=Bell's palsy: Treatment guidelines. | journal=Ann Indian Acad Neurol | year= 2011 | volume= 14 | issue= Suppl 1 | pages= S70-2 | pmid=21847333 | doi=10.4103/0972-2327.83092 | pmc=3152161 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21847333 }} </ref><ref name="pmid5573820">{{cite journal| author=Hauser WA, Karnes WE, Annis J, Kurland LT| title=Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. | journal=Mayo Clin Proc | year= 1971 | volume= 46 | issue= 4 | pages= 258-64 | pmid=5573820 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5573820 }} </ref> | ||
*the main symptom is acute peripheral [[facial weakness]]. | *the main symptom is acute peripheral [[facial weakness]]. | ||
*Additional symptoms may include: | *Additional symptoms may include: | ||
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*[Subtype of disease/malignancy] is associated with the most favorable prognosis. | *[Subtype of disease/malignancy] is associated with the most favorable prognosis. | ||
*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis. | *The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Natural History, Complications, and Prognosis
Natural History
- The onset of Bell's palsy is sudden and symptoms typically peak fast, within a few days and include:[1][2]
- the main symptom is acute peripheral facial weakness.
- Additional symptoms may include:
- Pain in or behind the ear
- Numbness or tingling in the affected side of the face usually without any objective deficit on neurological examination
- Hyperacusis and disturbed taste on the ipsilateral anterior part of the tongue
Complications
- Common complications of [disease name] include:
- [Complication 1]
- [Complication 2]
- [Complication 3]
Prognosis
- Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
- Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
- The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
- [Subtype of disease/malignancy] is associated with the most favorable prognosis.
- The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
Natural History, Complications 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 on either the ipsilateral or contralateral side have been observed in 7 to 15% of patients.
References
- ↑ Murthy JM, Saxena AB (2011). "Bell's palsy: Treatment guidelines". Ann Indian Acad Neurol. 14 (Suppl 1): S70–2. doi:10.4103/0972-2327.83092. PMC 3152161. PMID 21847333.
- ↑ Hauser WA, Karnes WE, Annis J, Kurland LT (1971). "Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota". Mayo Clin Proc. 46 (4): 258–64. PMID 5573820.