Bell palsy - facial nerve neuritis ; idiopathic, the most common form of facial paralysis. It occurs in approximately 23 people per 100,000 annually or in one person for 60–70 throughout life. The pathogenesis of the disease is unknown. Sometimes autopsy revealed only nonspecific changes in the facial nerve, which, however, were not inflammatory, as they are considered.
| Bell palsy | |
|---|---|
 A man with Bell palsy on the right side of his face trying to show his teeth and raise his eyebrows. | |
| ICD-10 | G 51.0 |
| ICD-10-KM | |
| ICD-9 | 351.0 |
| ICD-9-KM | |
| Diseasesdb | 1303 |
| Medlineplus | 000773 |
| eMedicine | emerg / 56 |
| Mesh | D020330 |
Named after Charles Bell , a 19th century Scottish physiologist.
Content
Clinical manifestations
Bell's paralysis begins suddenly, the maximum severity of weakness, as a rule, reaches after 48 hours. 1-2 days before the development of paralysis, the patient may feel pain behind the ear. Sometimes taste sensitivity is lost and hyperacusis is present. In some patients, mild pleocytosis is detected. Up to 80% of patients recover within a few weeks or months. Electromyographic signs of denervation 10 days later indicate axonal degeneration and that regeneration occurs with a long delay and may be incomplete. Electromyography helps to differentiate a temporary conduction defect from an anatomical interruption in the course of nerve fibers. If the patient is diagnosed with incomplete paralysis during the first week of illness, this serves as a favorable prognostic sign.
Treatment
Shown are eye protection measures during sleep, massage of weakened muscles and a splint that prevents lowering of the lower part of the face. A course of prednisone may be effective, starting with 60–80 mg daily in the first 5 days. In the next 5 days, the dose of the drug is gradually reduced. Surgical decompression of the facial nerve in its channel is recommended, but there is no evidence in favor of the effectiveness of this method. Moreover, its effects may be detrimental.
Notes
- ↑ Disease Ontology release 2019-05-13 - 2019-05-13 - 2019.
- ↑ Monarch Disease Ontology release 2018-06-29sonu - 2018-06-29 - 2018.