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BMJ. 2001 Oct 20; 323(7318): 935.
PMCID: PMC1121451

Bell's phenomenon should not be regarded as pathognomonic sign

David H Jones, specialist registrar ophthalmology

Editor—Although Minerva provides welcome light hearted news at the end of the weekly trawl through the BMJ, I must comment on the picture in the issue of 14 July of the male patient with Bell's phenomenon.1

Bell's phenomenon is a normal defence reflex present in about 75% of the population, resulting in elevation of the globes when blinking or when threatened (try touching your cornea with your finger, for example). It becomes noticeable only when the orbicularis muscle becomes weak as in, for example, bilateral facial palsy associated with the Guillain-Barré syndrome. It is, however, present behind forcibly closed lids in most healthy people and should not be regarded as a pathognomonic sign.


1. Smith J, Henderson B. (Minerva.) BMJ. 2001;323:118. . (14 July.)

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