1 / 8

Bells Palsy

Bells Palsy. Aetiology . Most cases unknown Most likely cause is viral. Incidence. Commonest in age group 10-40yrs 20 cases per 100,000 people. Examination. Differentiate between upper and lower motor neurone lesion

omer
Télécharger la présentation

Bells Palsy

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Bells Palsy

  2. Aetiology • Most cases unknown • Most likely cause is viral

  3. Incidence • Commonest in age group 10-40yrs • 20 cases per 100,000 people

  4. Examination • Differentiate between upper and lower motor neurone lesion • UML: frontalis is spared allowing normal furrowing of brow and eye blinking • LML: all muscles of facial expression are affected

  5. Examination continued • Check no other cranial nerves involved (BP is an isolated VII lesion) • Look for a painful rash over the ears (Ramsay Hunt caused by H zoster)

  6. Red flags which may necessitate referral • Bilateral BP • Recurrent BP • Association with rash elsewhere or with feeling generally unwell (sarcoid or Lyme disease) • Previous episode which might have been demyelination • ?SOL

  7. Treatment • Prednislone 1mg/kg up to 80mg max per day tailing off in second week (reduces oedema) • Aciclovir 800mg 5x daily for 5days given within first 72hrs (prevents viral replication) • Consider tape/eye pad so patient can sleep • Consider prescription for artificial tears • Reassure patient that he hasn’t had a CVA

  8. Follow up • 2/3rds of patients have spontaneous recovery • 85% show improvement in the first 3/52 • 15% show some improvement in 3-6/12 • Refer all cases to ENT after initiating Rx • Consider referral to eye specialist for tarsorrhaphy for those patients who have failed to make a complete recovery

More Related