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Bell Palsy: Rapid Evidence Review
Sarah N Dalrymple1, Jessica H Row1, John Gazewood1
1University of Virginia, Charlottesville, Virginia.
American Family Physician
|April 13, 2023
Summary
Bell palsy, a sudden facial paralysis, often resolves spontaneously, especially in children and pregnant women. Early corticosteroid treatment is recommended, with antivirals potentially reducing nerve regrowth issues.
Area of Science:
- Neurology
- Otolaryngology
Background:
- Bell palsy presents as acute, unilateral facial weakness or paralysis, often affecting the forehead.
- Idiopathic facial nerve paralysis typically has a favorable prognosis with spontaneous recovery in over two-thirds of cases.
- Recovery rates can reach 90% in pediatric and pregnant populations.
Purpose of the Study:
- To outline diagnostic criteria for Bell palsy.
- To review current treatment guidelines for Bell palsy.
- To discuss the efficacy of various therapeutic interventions.
Main Methods:
- Diagnosis relies on clinical presentation, excluding other neurological causes.
- Laboratory tests and imaging are generally not required for typical Bell palsy diagnosis.
- Treatment strategies include oral corticosteroids and, in some cases, antiviral medications and physical therapy.
Main Results:
- Over two-thirds of patients experience complete spontaneous recovery from Bell palsy.
- Oral corticosteroids are the primary treatment, with a specific dosage regimen recommended.
- Combination therapy with corticosteroids and antivirals may decrease the incidence of synkinesis.
Conclusions:
- Bell palsy diagnosis is primarily clinical, with a generally good prognosis.
- Corticosteroids are the first-line treatment; antiviral monotherapy is ineffective.
- Physical therapy can be a valuable adjunct for severe paralysis cases.
