(GP)

Overview

• Acute unilateral peripheral facial nerve palsy in patients for whom physical examination and history are otherwise unremarkable
• Deficits affecting all facial zones equally that fully evolve within 72 hours
• M=F, most common in people 15-45 yrs old
• 60% are preceded by an upper respiratory tract infection → suggests a viral or post-viral aetiology
• Herpes simplex virus type 1 (HSV-1) has strong correlation with Bell's Palsy
• Common in pregnant women

Making Diagnosis

Clinical Features:

• Unilateral facial weakness and droop
• Non-Forehead Sparing → LMN Lesion (ipsilateral) (forehead sparing indicates a contralateral UMN lesion, eg. stroke)
• Involvement of all nerve branches → equal distribution to all facial nerve branches
• Dry eye and mouth
  • Dry Eye ⇒ keratoconjunctivitis sicca
• Loss of taste on anterior 2/3 of tongue
• Hypersensitivity to loud noises → hyperacuisis