A general practice approach to Bell's palsy.
BACKGROUND
Bell's palsy is characterised by an acute onset of unilateral, lower motor neuron weakness of the facial nerve in the absence of an identifiable cause. Establishing the correct diagnosis is imperative and choosing the correct treatment options can optimise the likelihood of recovery.


OBJECTIVE
This article summarises our understanding of Bell's palsy and the evidence-based management options available for adult patients.


CONCLUSIONS
The basic assessment should include a thorough history and physical examination as the diagnosis of Bell's palsy is based on exclusion. For confirmed cases of Bell's palsy, corticosteroids are the mainstay of treatment and should be initiated within 72 hours of symptom onset. Antiviral therapy in combination with corticosteroid therapy may confer a small benefit and may be offered on the basis of shared decision making. Currently, no recommendations can be made for acupuncture, physical therapy, electrotherapy or surgical decompression because well-designed studies are lacking and available data are of low quality.
Nga T
NT
Phan
Benedict
B
Panizza
Benjamin
B
Wallwork
D000212:Acyclovir / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D020330:Bell Palsy / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D019468:Disease Management; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000379:methods; D005260:Female; D058006:General Practice / Q000379:methods*; D006801:Humans; D008297:Male; D011241:Prednisone / Q000494:pharmacology / Q000627:therapeutic use; D000077483:Valacyclovir; D014633:Valine / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D011241:Prednisone; D000212:Acyclovir