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Bell Palsy

 Syn. Bells palsy

Signs & Symptoms

 Unilateral facial paralysis #Criteria
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
Sudden onset #Criteria
Note: Usually over hours
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
Eyebrow sagging
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
Vesicles in the external meatus (negative symptom)
Note: Raise the possibility of Herpes zoster
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]

Physical Examination

 Vesicles in the external meatus (negative symptom)
Note: Raise the possibility of Herpes zoster
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
Preherpetic neuralgia (negative symptom)
Note: Dermatomal pain and dysesthesia that occurs before the presence of vesicles/Raise, Raise the possibility of Herpes zoster
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
Presence of spontaneous facial movement (negative symptom)
Note: As in smiling
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]

Lab / Serology

 liver function test abnormalities (negative symptom)
Note: Raise the possibility of Lyme disease
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
microhematuria (negative symptom)
Note: Raise the possibility of Lyme disease
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]

Imagin Study

 Enhancement of the geniculate ganglion within the facial canal
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
Enhancement of the tympanic-mastoid segment within the facial canal
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
Degree of axonal damage
Note: Needle EMG, At approximately 20 to 30 days after onset
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]

Complication

Risk Factors

 Pregnant
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
Diabetic
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]

Cause

 Herpes simplex virus activation
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
Herpes zoster
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]
Cytomegalovirus
Ref: Uptodate [ Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults]

Other