Bell's palsy

doi:10.1136/bmj.330.7504.1374

BMJ 2005;330:1374 (11 June), doi:10.1136/bmj.330.7504.1374

Primary care

10-minute consultation

Bell's palsy

Jo Piercy, clinical lecturer¹

¹ Division of Medical Education, Warwick Medical School, University of Warwick, Coventry CV4 7AL Joanna.piercy@warwick.ac.uk

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

Introduction

A 32 year old man presents to you with sudden onset of weaknesson the left side of his face. He also says that he is unableto close his left eye. He is otherwise well and last saw a doctorfive years ago. He is anxious and thinks he has had a stroke.

What issues you should cover

Associated symptoms—Patients with Bell's palsy commonlyfeel pain in or behind the ear. Numbness can occur on the affectedside of the face. Loss of taste on the ipsilateral anteriortwo thirds of the tongue is common. Ask about associated hyperacusisand any presence of rash that may indicate herpes zoster.

Aetiology—Ask about recent viral infection and recentimmunisation. The causes of Bell's palsy are unknown, but thepossibilities include viral infection, heredity, autoimmuneor vascular ischaemia, of which the most likely cause is viral.

Incidence—Bell's palsy is commonest in the age group . . . [Full text of this article]

What you should do

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