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Bell’s palsy

Definition:

  • Bell’s Palsy is a form of temporary facial paralysis or weakness on one side of the face due to dysfunction of the facial nerve (cranial nerve VII).

Epidemiology:

  • Most common cause of facial paralysis.
  • Can occur at any age, but more common between ages 15 and 60.
  • No significant gender difference in incidence.

Etiology:

  • Exact cause is often unknown.
  • Thought to be associated with viral infections, particularly the herpes simplex virus.

Pathophysiology:

  • Inflammation and swelling of the facial nerve, likely due to a viral infection, leading to compression and ischemia within the narrow fallopian canal.

Clinical Features:

  • Sudden onset of unilateral facial weakness or paralysis.
  • Inability to raise eyebrow, smile, or close eye on the affected side.
  • Loss of forehead creases.
  • May have altered taste, hyperacusis (increased sensitivity to sound), or decreased tear and saliva production on the affected side.

Diagnosis:

  • Clinical diagnosis based on history and physical examination.
  • No specific tests are usually required, but imaging (like MRI) may be done to rule out other causes in atypical cases.

Management:

  • Most cases spontaneously recover within weeks to months.
  • Corticosteroids are often prescribed to reduce nerve inflammation.
  • Eye care to prevent dryness and injury to the cornea (e.g., artificial tears, eye patch).
  • Physiotherapy for facial muscle exercises.

Prognosis:

  • Good prognosis; most patients recover completely, especially if treatment is started early.
  • Some may have residual facial weakness, synkinesis (involuntary movements), or contractures.

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