Bell palsy: Difference between revisions
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* [[Ramsay Hunt syndrome]] ([[VZV]]) |
* [[Ramsay Hunt syndrome]] ([[VZV]]) |
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* Lyme disease (may be bilateral, with or without meningitis) |
* [[Lyme disease]] (may be bilateral, with or without meningitis) |
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* Complication of [[Acute otitis media|otitis media]], [[mastoiditis]], or [[cholesteatoma]] |
* Complication of [[Acute otitis media|otitis media]], [[mastoiditis]], or [[cholesteatoma]] |
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* [[Guillain-Barré syndrome]] |
* [[Guillain-Barré syndrome]] |
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Latest revision as of 22:15, 27 January 2025
Background
- Idiopathic unilateral facial nerve palsy (not sparing forehead)
- Suspected etiologies include HSV-1 or other viral infection
Differential Diagnosis
- Ramsay Hunt syndrome (VZV)
- Lyme disease (may be bilateral, with or without meningitis)
- Complication of otitis media, mastoiditis, or cholesteatoma
- Guillain-Barré syndrome
- HIV, with or without opportunistic infection
- Sarcoidosis
- Sjögren syndrome
- Tumour
- Stroke, typically sparing the forehead and eyelid muscles
Management
- Corticosteroids (NNT 50 for mild-to-moderate, 8 for severe)
- No role for antivirals alone, but can consider adding in cases of severe Bell palsy
Further Reading
- de Almeida JR, et al. Management of Bell palsy: clinical practice guideline. CMAJ. 2014;186(12)917-922.
