Bell's palsy: Difference between revisions
(Created page with "==Background== *Dysfunction of peripheral CN VII of unknown cause *Maximal clinical weakness around 3wks; at least partial recovery by 6 months ==DDX== #Lyme Disease #HIV #Otiti...") |
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*Dysfunction of peripheral CN VII of unknown cause | *Dysfunction of peripheral CN VII of unknown cause | ||
*Maximal clinical weakness around 3wks; at least partial recovery by 6 months | *Maximal clinical weakness around 3wks; at least partial recovery by 6 months | ||
*Always test CN VI function (should be normal) to rule-out CVA | |||
==DDX== | ==DDX== | ||
Revision as of 20:32, 29 October 2011
Background
- Dysfunction of peripheral CN VII of unknown cause
- Maximal clinical weakness around 3wks; at least partial recovery by 6 months
- Always test CN VI function (should be normal) to rule-out CVA
DDX
- Lyme Disease
- HIV
- Otitis Media
- Sarcoidosis (esp if b/l)
Clinical Features
- Acute onset (over hours) of unilateral facial paralysis
- No forehead sparing
- Mouth drawn to the non-affected side
- Incomplete closure of the eyelids on the affected side
- Can lead to corneal exposure keratitis
Treatment
- Cornea
- Artificial tears qhr while pt is awake; ophthalmic ointment at night
- Protective glasses or goggles
- Corticosteroids
- Give to all pts
- Prednisone 60-80mg/day x1wk
- Antivirals
- Controversial efficacy; may have benefit in pts w/ severe palsy
- Valacyclovir 1000mg TID x1wk
Disposition
- Discharge with ophto f/u for monitoring of the affected cornea
Source
Tintinalli