Bell’s palsy
·Acute paralysis of the muscles of
facial expression may be unable to close the eye on the affected side.
·Normally unilateral, but may be
bilateral lower motor neuron lesion.
·2o to oedema of the facial nerve as
it passes through the temporal bone.
·Idiopathic.
·Varicella and other viruses.
·Borrelia
burgdorferi (Lyme
disease), particularly if bilateral.
·Check:
whether other branches of the
facial nerve are affected, e.g. hyperacusis.
·Full
systemic examination: in
particular, look for signs of leukaemia and
vasculitides.
·Full
neurological examination: look
for other signs, the presence of which
would exclude an idiopathic Bell’s palsy.
·FBC and film (leukaemia).
·Varicella titres.
·Borrelia investigation, in
suspicious cases, only after discussion with microbiology as this is a
difficult infection to either refute or confirm.
·Steroids:
evidence for the use of steroids
is limited, but the general opinion
is to use 2mg/kg (maximum 60mg) prednisolone, once daily for 5 days if the
symptoms are less than 7 days old.
·Aciclovir: recent evidence indicates that
oral aciclovir (40mg/kg/day) for 10
days, irrespective of varicella status, may be useful.
Most children will either recover
fully or recover to a good degree. When this does not occur
after 6mths, referral for facial nerve grafting is appropriate.
Related Topics
Privacy Policy, Terms and Conditions, DMCA Policy and Compliant
Copyright © 2018-2024 BrainKart.com; All Rights Reserved. Developed by Therithal info, Chennai.