Bells Palsy

Posted On April 6, 2020

Bell’s palsy involve the 7th cranial nerve and results in paralysis of the facial muscles, both the upper and lower part of the face.

• Evaluate eye closure
  • may need eye protection
• Mild to moderate
  • Prednisone 60-80 daily for 7 days
• Severe to complete
  • Prednisone as above
  • Valacyclovir (Valtrex) 1 gram tid for 7 days
• Incomplete recovery: consider botox
• Other therapy:
  • physical therapy: electrical stimulation, exercise, acupuncture. Did not seem to improve the chance of recovery
  • Surgical decompression: not recommended.
• Prognosis:
  • 85% signs of recovery in 3 weeks
  • 71% complete recovery
  • 13% slight sequelae
  • 16% residual weakness, synkinesis
• Recurrence
  • 7-15%
  • mean time to recurrence: 10 years
  • Pregnancy may be a risk factor for recurrence