Format

Send to

Choose Destination
Am Fam Physician. 2014 Feb 1;89(3):209-12.

Common questions about Bell palsy.

Author information

1
Southern Illinois University-Springfield Family Medicine Residency Program, Springfield, IL, USA.
2
Regional Health, Rapid City, SD, USA.

Abstract

Bell palsy is an acute affliction of the facial nerve, resulting in sudden paralysis or weakness of the muscles on one side of the face. Testing patients with unilateral facial paralysis for diabetes mellitus or Lyme disease is not routinely recommended. Patients with Lyme disease typically present with additional manifestations, such as arthritis, rash, or facial swelling. Diabetes may be a comorbidity of Bell palsy, but testing is not needed in the absence of other indications, such as hypertension. In patients with atypical symptoms, magnetic resonance imaging with contrast enhancement can be used to rule out cranial mass effect and to add prognostic value. Steroids improve resolution of symptoms in patients with Bell palsy and remain the preferred treatment. Antiviral agents have a limited role, and may improve outcomes when combined with steroids in patients with severe symptoms. When facial paralysis is prolonged, surgery may be indicated to prevent ocular desiccation secondary to incomplete eyelid closure. Facial nerve decompression is rarely indicated or performed. Physical therapy modalities, including electrostimulation, exercise, and massage, are neither beneficial nor harmful.

PMID:
24506123
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for American Academy of Family Physicians
Loading ...
Support Center