Bell’s Palsy

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Bell's palsy, also referred to as idiopathic facial nerve palsy is unilateral paralysis of all the muscles  of facial expression of suspected viral etiology. Inflammation and edema of the facial nerve likely 
play a role in pathogenesis. Reactivation of herpes simplex virus (HSV) is also thought to play an  etiologic role. Most patients recover within a few weeks or months.  

Clinical presentation 

  • Unilateral facial paralysis (sudden onset)
  • Inability to close the eye

Investigations 

  • HIV testing
  • RBG
  • otoscopic exam

Pharmacological management 

A: prednisolone (PO) 60mg 24hourly for 5 days, then taper down to 50mg 24hourly for next 5days.  

AND 

B: acyclovir (PO/IV)800mg 4-8hourly for 7-14days. 

Non-pharmacological management 

  • Provide facial muscle massage and exercises
  • Provide eye patch for ocular protection during sleep.
  • Refer for ophthalmological evaluation in severe cases