Bell’s Palsy
Not yet clinically reviewed
This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.
Bell's palsy is a condition that causes sudden weakness in the muscles on one side of the face. In most cases, the weakness is temporary and significantly improves over weeks. The weakness makes half of the face appear to droop. Smiles are one-sided, and the eye on the affected side resists closing.
Signs and symptoms
- Rapid onset of mild weakness to total paralysis on one side of your face — occurring within hours to days
- Facial droop and difficulty making facial expressions, such as closing your eye or smiling
- Drooling
- Pain around the jaw or in or behind your ear on the affected side
- Increased sensitivity to sound on the affected side
- Headache
- A loss of taste
- Changes in the amount of tears and saliva you produce
Causes
- Cold sores and genital herpes (herpes simplex)
- Chickenpox and shingles (herpes zoster)
- Infectious mononucleosis (Epstein-Barr)
- Cytomegalovirus infections
- Respiratory illnesses (adenovirus)
- German measles (rubella)
- Mumps (mumps virus)
- Flu (influenza B)
- Hand-foot-and-mouth disease (coxsackievirus)
Diagnosis
EMG, MRI, CT-scan, Blood tests
Treatment
Tab Deltacortel (prednisolone) 5mg, 5+5 tab for 10 days 'OR'
6+6 for 5 days
5+5 on day 6 4+4 on day 7
3+3 on day 8 2+2 on day 9
1+1 on day 10.
Tab-Acylex (acyclovir) 200-400mg, 1 tab PO x QID for 10 days (when there is evidence of herpetic vesicles in the external ear canal).
Use Tear plus eye drops (2 drops QID) during the day in the effected eye and apply Chloramphenicol ointment to the affected eye at night till the patient can close the eye.
Tab- Becefol 1 tab PO x OD for 1 month.
Physiotherapy
Speech and language therapy