Idiopathic Facial Nerve Palsy (Bell's Palsy)

Bell''s palsy is a benign common neurological disorder of unknown cause. It is almost always unilateral. It is the most common disease of the facial nerve. The incidence rate is 13 34 per 100000 and it is more common in third to fifth decade with variable sex patterns. Relationship between Bell�s palsy and pregnancy, hypertension, diabetes mellitus is noted in some studies. Onset of symptoms is acute and mostly, entire paralysis occurs in 48 hours. Paralysis may be preceded by pain behind the ear for one or two days. Diagnosis of Bell�s palsy is usually made be history and physical. The most important part of the diagnosis is determinating the location of the lesion. Principles of management include eye protection during sleep, massage of the weakened muscles, medications (e.g., steroids, Acyclovir, Vitamin B complex) and surgical decompression of the facial nerve. About 80% of patients attain full recovery within a few weeks, which usually is initiated with taste recovery and followed, by motor recovery. Prognosis is probably affected by the severity of the symptoms. Concomitant diseases such as diabetes mellitus have probably no effect to the prognosis of the Bell�s palsy