Symptoms and signs
- Age 10-40
- LMN lesion affecting the 7th cranial nerve only
- May have facial numbness
- May have loss of taste on the antr 2/3 of tongue on the same side
- May have pain behind the ear
Differential diagnosis
- Herpes zoster (rash, hyperacusis) - Ramsay Hunt syndrome
- CVA (UMN lesion - with an upper motor neurone lesion
frontalis is spared, normal furrowing of the brow is preserved,
and eye closure and blinking are not affected)
- Lyme disease (malaise)
- Recurrent (demyelination)
- SOL
Management
- 80% improve spontaneously. 85% report some improvement in the
first three weeks. In the other 15% of patients, some improvement
occurs by 3-6 months.
- A further 17% improve with steroids (prednisolone 1 mg/kg/day
(max 80 mg daily) for the first week, tapering off over the
second week) given in the first 7 days.
- Recovery rates enhanced if patients treated with aciclovir (800mg 5
times a day for 5 days) within 72 hours - 7 days.
- Tape eye or eye pad if lid affected.
- Artificial tears
- Explore concerns
- Consider indications for |ENT referral.
Information for patients
Useful reading
Bell's
palsy