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Updated: Dec 20, 2025

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Facial Nerve Palsy: Clinical Practice and Cognitive Errors.

Elizabeth George1, Megan B Richie2, Christine M Glastonbury1

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PubMed
Summary

Idiopathic facial nerve paralysis, commonly known as Bell palsy, is diagnosed through examination and observation of recovery. Replacing the eponym "Bell palsy" with "idiopathic facial nerve paralysis" can prevent diagnostic errors.

Keywords:
Bell palsyDiagnostic errorFacial palsyPremature closure

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Area of Science:

  • Neurology
  • Otolaryngology

Background:

  • Facial paralysis is the most frequent cranial nerve paralysis, with most cases being idiopathic.
  • Idiopathic facial nerve paralysis (Bell palsy) presents acutely, affects the whole face, and typically resolves spontaneously.

Purpose of the Study:

  • To recommend replacing the eponym "Bell palsy" with "idiopathic facial nerve paralysis" to avoid diagnostic errors.
  • To highlight the importance of accurate diagnosis in facial paralysis cases.

Main Methods:

  • Review of clinical presentation and diagnostic criteria for facial paralysis.
  • Analysis of potential cognitive errors associated with using the eponym "Bell palsy".

Main Results:

  • The diagnosis of idiopathic facial paralysis relies on history, physical examination, and monitoring for recovery.
  • Atypical presentations or lack of recovery suggest alternative causes requiring further investigation.

Conclusions:

  • The term "Bell palsy" is often misused for all facial paralysis types, leading to diagnostic errors like premature closure and anchoring bias.
  • Accurate terminology, such as "idiopathic facial nerve paralysis," is crucial for precise diagnosis and patient care.