Bell’s palsy, also referred to as idiopathic facial nerve palsy or facial nerve palsy of suspected viral etiology, is the most common cause of acute spontaneous peripheral facial paralysis.
Patients with Bell’s palsy typically present with the sudden onset (usually over hours) of unilateral facial paralysis. Common findings include the eyebrow sagging, inability to close the eye, disappearance of the nasolabial fold, and drooping at the affected corner of the mouth, which is drawn to the unaffected side.
Decreased tearing, hyperacusis, and/or loss of taste sensation on the anterior two-thirds of the tongue may help to site the lesion in the fallopian canal, but these findings are of little practical use other than as indicators of severity.
The diagnosis of Bell’s palsy is based upon the following criteria:
1. There is a diffuse facial nerve involvement manifested by paralysis of the facial muscles, with or without loss of taste on the anterior two-thirds of the tongue or altered secretion of the lacrimal and salivary glands.
2. Onset is acute, over a day or two; the course is progressive, reaching maximal clinical weakness/paralysis within three weeks or less from the first day of visible weakness; and recovery or some degree of function is present within six months.
The Manhattan Center for Headache and Neurology has competent providers to further evaluate and facilitate acute and extended management.
Jordan Shankle, PA