Bell's palsy differential diagnosis: Difference between revisions
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{{Bell's palsy}} | {{Bell's palsy}} | ||
{{CMG}} | {{CMG}} | ||
==Overview== | |||
==Differential diagnosis of Bell's palsy== | ==Differential diagnosis of Bell's palsy== | ||
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*Screening for antibodies to B. burgdorferi not recommended among patients with seventh nerve palsy with no additional manifestations of Lyme disease. | *Screening for antibodies to B. burgdorferi not recommended among patients with seventh nerve palsy with no additional manifestations of Lyme disease. | ||
*Findings suggestive of possible [[Lyme disease]] include the development of facial palsy in a young patient, heart block, arthritis, vertigo, and hearing loss. | *Findings suggestive of possible [[Lyme disease]] include the development of facial palsy in a young patient, heart block, arthritis, vertigo, and hearing loss. | ||
===HIV=== | ===HIV=== | ||
*HIV infection rarely causes facial palsy. | *HIV infection rarely causes facial palsy. | ||
*Onset at the time of sero-conversion when a [[CSF]] lymphocytosis is usually present. | *Onset at the time of sero-conversion when a [[CSF]] lymphocytosis is usually present. | ||
*In the later stages when cellular immunity wanes, the facial palsy is typically due to another infection such as Zoster, chronic demyelinating polyradiculopathy, or meningeal [[lymphomatosis]]. | *In the later stages when cellular immunity wanes, the facial palsy is typically due to another infection such as Zoster, chronic demyelinating polyradiculopathy, or meningeal [[lymphomatosis]]. | ||
===Melkersson-Rosenthal Syndrome=== | ===Melkersson-Rosenthal Syndrome=== | ||
*Facial paralysis, episodic facial swelling, and a fissured tongue, typically beginning in adolescence, with recurrent episodes of facial palsy. | *Facial paralysis, episodic facial swelling, and a fissured tongue, typically beginning in adolescence, with recurrent episodes of facial palsy. | ||
*Incomplete forms of this syndrome outnumber those with the classic triad. | *Incomplete forms of this syndrome outnumber those with the classic triad. | ||
*The cause is unknown, and treatment unproven. | *The cause is unknown, and treatment unproven. | ||
===Other Entities=== | ===Other Entities=== | ||
*Bacterial infection of the middle ear ([[otitis media]]) | *Bacterial infection of the middle ear ([[otitis media]]) | ||
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==References== | ==References== | ||
{{ | {{Reflist|2}} | ||
[[Category:Neurological disorders]] | [[Category:Neurological disorders]] | ||
[[Category:Otolaryngology]] | [[Category:Otolaryngology]] | ||
Revision as of 04:03, 29 July 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Differential diagnosis of Bell's palsy
Lyme Disease
- Facial nerve palsy is the most common cranial neuropathy associated with Lyme meningitis.
- Screening for antibodies to B. burgdorferi not recommended among patients with seventh nerve palsy with no additional manifestations of Lyme disease.
- Findings suggestive of possible Lyme disease include the development of facial palsy in a young patient, heart block, arthritis, vertigo, and hearing loss.
HIV
- HIV infection rarely causes facial palsy.
- Onset at the time of sero-conversion when a CSF lymphocytosis is usually present.
- In the later stages when cellular immunity wanes, the facial palsy is typically due to another infection such as Zoster, chronic demyelinating polyradiculopathy, or meningeal lymphomatosis.
Melkersson-Rosenthal Syndrome
- Facial paralysis, episodic facial swelling, and a fissured tongue, typically beginning in adolescence, with recurrent episodes of facial palsy.
- Incomplete forms of this syndrome outnumber those with the classic triad.
- The cause is unknown, and treatment unproven.
Other Entities
- Bacterial infection of the middle ear (otitis media)
- Cholesteatoma, or tumors should be suspected if the onset of facial palsy is gradual.
- Sarcoidosis, especially in patients with bilateral facial palsy.
- Sjogren's syndrome is an unusual cause.