Bell's palsy - NHS video

Bell’s palsy is the abrupt paralysis of the facial nerve (cranial nerve 7, CN7), resulting in an inability to control facial muscles on the affected side. A common condition, Bell’s palsy has an annual incidence of 11-40 cases per 100 ,000 population. Many patients recover without intervention; however, up to 30% have poor recovery of facial muscle control and experience facial disfigurement, psychological trauma, and facial pain.

From the NHS Choices YouTube channel: Bell's palsy is the temporary weakness or paralysis of the muscles in one side of the face. In this video, a speech therapist explains who is most at risk and describes common causes and treatment options available. Helen explains how she dealt with the condition and recovered from it:



Remember:

U MN damage
U pper face is OK (the patient is able to wrinkle his forehead)

LMN damage = patient is unable to wrinkle his forehead (our patient)

The examination of CN 7 palsy can be remembered by the mnemonic COWS:

C lose your eyes
O pen (the examining physician tries to open the patient's eyes)
W rinkle your forehead
S mile

Two main types of pharmacological treatment have been used to improve outcomes from Bell’s palsy:

- steroids
- antivirals.

The rationale for these treatments is based on the presumed pathophysiology of Bell’s palsy, namely inflammation and viral infection.

In a 2009 study published in the BMJ antivirals did not provide an added benefit in achieving at least partial facial muscle recovery compared with steroids alone in patients with Bell’s palsy.

References:

The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis | BMJ http://bit.ly/YD3iLG