Recent developments in Bell's palsy

doi:10.1136/bmj.329.7465.553

BMJ 2004;329:553-557 (4 September), doi:10.1136/bmj.329.7465.553

Clinical review

Recent developments in Bell's palsy

N Julian Holland, specialist registrar¹, Graeme M Weiner, consultant¹

¹ Department of Otolaryngology, Royal Devon and Exeter NHS Foundation Trust, Exeter EX2 5DW

Correspondence to: N J Holland njulianholland@hotmail.com

The first 150 words of the full text of this article appear below.

Introduction

General practitioners in the United Kingdom will see about onepatient with Bell's palsy every two years. Increasing evidenceshows that the way the patient is managed has an important effecton outcome. Untreated Bell's palsy leaves some patients withmajor facial dysfunction and a reduced quality of life. Of patientswith Bell's palsy registered by general practitioners between1992 and 1996 a fifth were referred for specialist opinion,just over a third received oral steroids, and 0.6% receivedaciclovir.¹ Improving outcomes requires coordination betweenspecialists and general practitioners so that patients are treatedduring the critical first 72 hours. We outline recent developmentsin Bell's palsy and current best evidence in its management.

Sources and selection criteria

We canvassed specialists with an interest in acute facial palsyand incorporated the latest consensus from key publicationsand systematic reviews. We performed a hierarchical literaturesearch through Medline, CINAHL, SUMSearch, bmj.com, Lancet NeurologyNetwork, Bandolier, . . . [Full text of this article]

Incidence and pathophysiology

Symptoms

Examination

Investigations

Zoster sine herpete

Bell's palsy in children

Outcomes

Treatment

Eye care
Corticosteroids
Antiviral agents
Aciclovir compared with prednisone
Aciclovir with prednisone
Treatment in children
Zoster sine herpete
Surgery
Physical therapies

Follow up

CiteULike

Complore

Connotea

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Bell's palsy: Jo Piercy
BMJ 2005 330: 1374. [Full Text] [PDF]

Recent developments in Bell's palsy: Does a more recent single research paper trump a systematic review?: James A Cave
BMJ 2004 329: 1103. [Extract] [Full Text]

Recent developments in Bell's palsy: Who should provide the care?: Adam Sandell
BMJ 2004 329: 1103. [Extract] [Full Text]

Recent developments in Bell's palsy: Trial for Bell's palsy is in progress in Scotland: Frank Sullivan, Fergus Daly, and Iain Swan
BMJ 2004 329: 1103-1104. [Extract] [Full Text]

Bell's palsy responds best to immediate treatment
BMJ 2004 329: 0. [Full Text]

This article has been cited by other articles:

Ohtake, P. J, Zafron, M. L, Poranki, L. G, Fish, D. R (2006). Does electrical stimulation improve motor recovery in patients with idiopathic facial (Bell) palsy?. ptjournal 86: 1558-1564 [Full text]
(2006). Managing Bell's palsy. DTB 44: 49-53 [Abstract] [Full text]
Piercy, J. (2005). Bell's palsy. BMJ 330: 1374-1374 [Full text]
Cave, J. A (2004). Recent developments in Bell's palsy: Does a more recent single research paper trump a systematic review?. BMJ 329: 1103-1103 [Full text]
Sandell, A. (2004). Recent developments in Bell's palsy: Who should provide the care?. BMJ 329: 1103-1103 [Full text]
Sullivan, F., Daly, F., Swan, I. (2004). Recent developments in Bell's palsy: Trial for Bell's palsy is in progress in Scotland. BMJ 329: 1103-1104 [Full text]
(2004). Hit parade. BMJ 329: 1051-1051 [Full text]

Rapid Responses:

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