შეჯამება
განსაზღვრება
ანამნეზი და გასინჯვა
ძირითადი დიაგნოსტიკური ფაქტორები
- single episode
- unilateral
- absence of constitutional symptoms
- involvement of all nerve branches
- keratoconjunctivitis sicca
- pain
- synkinesis
სხვა დიაგნოსტიკური ფაქტორები
- any age
- hyperacusis
- dysgeusia
რისკფაქტორები
- intranasal influenza vaccination
- pregnancy
- upper respiratory tract infection
- arid/cold climate
- hypertension
- family history of Bell's palsy
- diabetes
- dental procedures
დიაგნოსტიკური კვლევები
1-ად შესაკვეთი გამოკვლევები
- clinical diagnosis
- electroneuronography (ENoG) (evoked electromyography)
- needle electromyography
- serology for Borrelia burgdorferi
გასათვალისწინებელი კვლევები
- pure-tone audiometry
- tympanometry and stapedius reflex
- MRI (gadolinium-enhanced fine-cut of facial nerve course)
- CT (fine-cut, non-enhanced)
მკურნალობის ალგორითმი
all patients
კონტრიბუტორები
ავტორები
Matthew Q. Miller, MD
Assistant Professor Otolaryngology-Head and Neck Surgery
Director UNC Facial Nerve Center
University of North Carolina-Chapel Hill
Chapel Hill
NC
გაფრთხილება:
MQM is a paid consultant for Checkpoint Surgical, Inc.
Liliana Ein, MD
Assistant Professor Otolaryngology-Head and Neck Surgery
Division of Facial Plastic and Reconstructive Surgery
University of Miami
Miami
FL
გაფრთხილება:
LE declares that she has no competing interests.
მადლიერება
Dr Matthew Q. Miller and Dr Liliana Ein would like to gratefully acknowledge Dr Tessa Hadlock, Dr Nathan Jowett, Dr Vishnu Madhok, Dr Iain Swan, Dr Pauline Lockhart, Dr Michael Norbury, and Dr John Gail Neely, previous contributors to this topic.
გაფრთხილება:
TH, VM, IS, PL, MN, and JGN declare that they have no competing interests. NJ holds a patent on the methods and systems for functional electrical stimulation of the paralyzed face (WO2017124019A1).
რეცენზენტები
Giles Elrington, MBBS (Hons), MD, FRCP
Consultant Neurologist
Barts Health NHS Trust
London
UK
გაფრთხილება:
GE is involved in a number of clinical trials on multiple sclerosis sponsored by Genzyme, Roche, Teva, Novartis, Biogen, as well as one funded by the MRC. He is also involved in clinical trials sponsored by Allergan, NMT Medical, GlaxoSmithKline (GSK), Bristol-Myers, the UK's Parkinson's Disease Research Group, and Pharmacia. In addition, he has attended lectures, conferences and symposia with the following companies - GSK, AstraZeneca, MSD, Almirall, Pfizer, Menarini, Allergan, Biogen, Teva, Conference Plus, Infomed, and BMJ.
Patrick Grogan, MD
Major
US Air Force
MC Program Director
Department of Neurology
MMCN
Wilford Hall Medical Center
Lackland Air Force Base
TX
Disclosures
PG declares that he has no competing interests.
Venkat Srinivasan, MBBS, DLO, FRCS (Ed), FRCS (ORL)
Consultant in ENT/Thyroid Surgery
Arrowe Park Hospital
Upton
Wirral
UK
Disclosures
VS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg. 2013 Nov;149(3 Suppl):S1-27.Full text Abstract
Gronseth GS, Paduga R; American Academy of Neurology. Evidence-based guideline update: steroids and antivirals for Bell palsy. Neurology. 2012 (reaffirmed 2023) Nov 27;79(22):2209-13.Full text Abstract
Madhok VB, Gagyor I, Daly F, et al. Corticosteroids for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2016;(7):CD001942.Full text Abstract
Gagyor I, Madhok VB, Daly F, et al. Antiviral treatment for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2019 Sep 5;9:CD001869.Full text Abstract
Gantz BJ, Rubinstein JT, Gidley P, et al. Surgical management of Bell palsy. Laryngoscope. 1999 Aug;109(8):1177-88. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Herpes zoster oticus (Ramsay Hunt syndrome)
- Lyme disease
- Benign facial nerve tumor (e.g., facial nerve schwannoma)
More DifferentialsGuidelines
- ACR appropriateness criteria: cranial neuropathy
- Management of acute Bell's palsy
More GuidelinesPatient information
Bell palsy
More Patient information
Conectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal