Bell Palsy
Botulinum Toxins
Dysarthria
Dysgeusia
Paralysis

Bell Palsy

Bell palsy is the most common paralysis of the seventh cranial nerve, with an onset that is typically rapid and hemifacial. The condition affects 15 to 40 of every 100,000 people annually and recurs in approximately 10% of cases. In addition to unilateral facial paralysis, Bell palsy often also involves a prodrome of otalgia, and many patients additionally report ipsilateral xerophthalmia, epiphora, hyperacusis, nasal obstruction, and dysgeusia. The facial asymmetry accompanying Bell palsy may cause dysarthria, oral incompetence, and difficulty expressing emotions nonverbally, resulting in social isolation and emotional distress. Fortunately, 70% to 80% of patients will recover completely even without treatment, and over 95% recover with prompt pharmacological therapy. In rare cases, surgical intervention may be indicated to protect the eye or improve recovery of facial nerve function. Imaging and laboratory evaluation are unnecessary in most cases, but patients with severe paralysis may undergo electrodiagnostic testing for its prognostic value and to establish candidacy for facial nerve decompression surgery. For patients who do not fully recover from Bell palsy, spastic and dyscoordinated facial contractions (synkinesis) usually develop, necessitating long-term treatment with physiotherapy, botulinum toxin injections, and potential surgical interventions. This activity for healthcare professionals reviews key aspects of Bell palsy, including its etiology, clinical presentation, differential diagnosis, and current approaches to treatment and rehabilitation, from initial presentation to long-term management. The activity also highlights the role of an interprofessional team in improving outcomes for affected patients.

Credit & MOC Details

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