Bell palsy: Difference between revisions
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* Idiopathic unilateral facial nerve palsy (not sparing forehead) |
* Idiopathic unilateral facial nerve palsy (not sparing forehead) |
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* Suspected etiologies include HSV-1 or other viral infection |
* Suspected etiologies include HSV-1 or other viral infection |
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| + | == Differential Diagnosis == |
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| + | * [[Ramsay Hunt syndrome]] ([[VZV]]) |
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| + | * Lyme disease (may be bilateral, with or without meningitis) |
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| + | * Complication of [[Acute otitis media|otitis media]], [[mastoiditis]], or [[cholesteatoma]] |
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| + | * [[Guillain-Barré syndrome]] |
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| + | * [[HIV]], with or without [[Opportunistic infections in HIV|opportunistic infection]] |
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| + | * [[Sarcoidosis]] |
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| + | * [[Sjögren syndrome]] |
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| + | * Tumour |
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| + | * Stroke, typically sparing the forehead and eyelid muscles |
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== Management == |
== Management == |
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Latest revision as of 14:11, 11 September 2023
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.
