Condition Info - BotMed Application

ConditionName

Facial Nerve Palsy (Bell's Palsy)

ConditionDescription

Symptoms

Rapid onset of mild weakness to total paralysis on one side of your face — occurring within hours to days;
Facial droop and difficulty making facial expressions, such as closing your eye or smiling;
Drooling;
Pain around the jaw or in or behind your ear on the affected side;
Increased sensitivity to sound on the affected side;
Headache;
A loss of taste;
Changes in the amount of tears and saliva you produce;

PhysicalFindings

Face feels stiff or pulled to one side;

Entire side of face paralysis;

Hyperacusis CN7 supplies stapedius - a shock absorber;

Taste disturbance. CN7 supplies sensation of teste to anterior 2/3 of tongue (sweet);

Sensation is intact;
Patient can wrinkle forehead or can’t lift up  on affected side;
DDx: stroke, Lyme (by history), OM (check ear);

ClinicalTests

Clinical evaluation;
CT or MRI;

Most accurate: electromyography and nerve conduction studies;

RiskFactors

IsRedFlag

IsNPLEX

Consequence

Acute 1-2 days, progressively worse 3 weeks, recovery within 6 m;
Difficulty closing eye;
Corneal ulceration – patient can’t close eyes;

ProgressionFromCondition

Idiopathic;
Lyme;
Sarcoidosis;
Herpes zoster;
Tumor;

TreatmentOptions

60% fully recovered without treatment;
Eye care! Lubricating ointment, path covering the eye at night;

PharmOptions

Prednisone (for 1 week);
+/- Valacyclovir;

WebLink

https://www.merckmanuals.com/en-ca/professional/neurologic-disorders/neuro-ophthalmologic-and-cranial-nerve-disorders/facial-nerve-palsy