Difference between revisions of "Bell's palsy"
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==DDX== | ==DDX== | ||
#Lyme Disease | #Lyme Disease | ||
− | #HIV | + | #[[HIV (Main)]]|HIV]] |
− | #Otitis Media | + | #[[Otitis Media]] |
#Sarcoidosis (esp if b/l) | #Sarcoidosis (esp if b/l) | ||
Revision as of 06:09, 5 December 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 (Main)|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 AND
- Ophthalmic ointment at night
- Protective glasses or goggles
- Corticosteroids
- Give to all pts
- Prednisone 60-80mg qday x1wk
- Antivirals
- Controversial efficacy; may have benefit in pts w/ severe palsy
- Valacyclovir 1000mg TID x1wk
Disposition
- Discharge with ophtho f/u for monitoring of the affected cornea
Source
- Tintinalli