Idiopathic Facial Paralysis (Bell’s palsy)

Bouguezzi Adel^1, , Souid Kawthar¹, Derbel Amine¹, Ben Youssef Souha¹ and Boughzala Abdellatif¹

¹Department of medicine and oral surgery, University Hospital Farhat Hached, Sousse, Tunisia

Cite this paper:
Bouguezzi Adel, Souid Kawthar, Derbel Amine, Ben Youssef Souha and Boughzala Abdellatif. Idiopathic Facial Paralysis (Bell’s palsy). International Journal of Dental Sciences and Research. 2014; 2(5A):1-4. doi: 10.12691/ijdsr-2-5A-1

Abstract

Bell’s palsy is defined as a neuropathy of the peripheral seventh cranial nerve or the facial nerve. It is usually from an idiopathic cause but it can result from traumatic, compressive, infective, inflammatory or metabolic abnormalities involving the facial nerve. Bell’s palsy is more common in adults than in children. We present a case of Bell’s palsy in an 38-year-old women who completely recovered after treatment with oral antiviral agents and steroids followed by regular facial physiotherapy. The dilemma in management of Bell’s palsy with a review of relevant literature is discussed in this report.

Keywords:
Bell’s palsy facial nerve oral acyclovir corticosteroids

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Phil TR, Bell C. On the nerves, giving an account of some experiments on their structure and functions which lead to a new arrangement of the system. Phil Trans Roy Soc Lond 1821; 111: 398-428.
[2]	Steiner I, Mattan Y. Bell’s palsy and herpes viruses: to acyclovir or not to (acyclo)vir?. J Neurol Sci. 1999; 170(1): 19-23.
[3]	Adour KK, Byl FM, Hilsinger RL Jr, Kahn ZM, Sheldon MI. The true natureof Bell’s palsy: analysis of 1,000 consecutive patients. Laryngoscope 1978; 88(5): 787-801.
[4]	Singhi P, Jain V. Bell’s palsy in children. Semin Pediatr Neurol 2003; 10(4): 289-97.
[5]	Hauser WA, Karnes WE, Annis J, Kurland LT. Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. Mayo Clin Proc 1971; 46: 258-264.
[6]	Adour KK, Ruboyianes JM, Von Doersten PG, et al. Bell’s palsy treatment with acyclovir and prednisone compared with prednisone alone: a double blind, randomized controlled trial. Ann Otol Rhinol Laryngol 1996; 105: 371-378.
[7]	Jeffrey D T, Nandini K. Bell’s Palsy: Diagnosis and Management. Am Fam Physician 2007; 76: 997-1002, 1004.
[8]	Adour K, Wingerd J, Doty HE. Prevalence of concurrent diabetes mellitus and idiopathic facial paralysis (Bell’s palsy). Diabetes 1975; 24: 449-51.
[9]	Keane JR. Bilateral seventh nerve palsy: analysis of 43 cases and review of the literature. Neurology 1994; 44: 1198-1202.
[10]	Yanagihara N, Honda N, Hato N, Murakami S. Edematous swelling of the facial nerve in Bell’s palsy. Acta Otolaryngol 2000; 120(5): 667-71.
[11]	Ahmed A. When is facial paralysis Bell palsy? Current diagnosis and treatment. Cleve Clin J Med 2005; 72(5): 398-401, 405.
[12]	Araujo MR, Azenha MR, Capelari MM, Marzola C. Management of Bell’s Palsy: A Report of 2 Cases. Journal (Canadian Dental Association). 2008; 74(9): 823-827.
[13]	Adour KK, Wingerd J, Bell DN, et al. Prednisone treatment for idiopathic facial paralysis (Bell’s palsy). N Engl J Med 1972; 287: 1268-1272.
[14]	Katusic SK, Beard CM, Wiederholt WC, et al. Incidence, clinical features, and prognosis in.
[15]	Brown JS. Bell’s palsy: A 5 year review of 174 consecutive cases: An attempted double blind study. Laryngoscope 1982; 92:1369-1373.
[16]	Williamson IG, Whelan TR. The clinical problem of Bell’s palsy: Is treatment with steroids.
[17]	Shafshak TS, Essa AY, Bakey FA. The possible contributing factors for the success of steroid therapy in Bell’s palsy: A clinical and electrophysiological study. J Laryngol Otol 1994; 108:940-943.
[18]	Austin JR, Peskind SP, Austin SG, et al. Idiopathic facial nerve paralysis: a randomized double blind controlled study of placebo versus prednisone. Laryngoscope 1993; 103: 1326-1333.
[19]	Ramsey MJ, Der Simonian R, Holter MR, et al. Corticosteroid treatment for idiopathic facial nerve paralysis: A meta-analysis. Laryngoscope 2000; 110(3 Pt 1): 335-341.
[20]	Salinas RA, Alvarez G, Daly F, Ferreira J. Corticosteroids for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2010; 17(3): CD001942.
[21]	May M, Wette R, Hardin WB Jr, et al. The use of steroids in Bell’s palsy: A prospective controlled study. Laryngoscope 1976; 86: 1111-1122
[22]	Stankiewicz JA. A review of the published data on steroids and idiopathic facial paralysis. Otolaryngol Head Neck Surg 1987; 97: 481-486.
[23]	Grogan PM, Gronseth GS. Practice parameter: Steroids, acyclovir, and surgery for Bell’s palsy (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001; 56: 830-836.
[24]	Prescott CA. Idiopathic facial nerve palsy in children and the effect of treatment with steroids. Int J Pediatr Otorhinolaryngol 1987; 13: 257-264.
[25]	Salman MS, MacGregor DL. Should children with Bell’s palsy be treated with corticosteroids? A systematic review. J Child Neurol 2001; 16: 565-568.
[26]	De Diego J I, Prim MP, De Sarriá MJ, et al. Idiopathic facial paralysis: A randomized, prospective, and controlled study using single-dose prednisone versus acyclovir three times daily. Laryngoscope 1998; 108(4 Pt 1): 573-575.
[27]	Axelsson S, Lindberg S, Stjernquist-Desatnik A. Outcome of treatment with valacyclovir and prednisone in patients with Bell’s palsy. Ann Otol Rhinol Laryngol 2003; 112: 197-201.
[28]	Hato N, Yamada H, Kohno H, et al. Valacyclovir and prednisolone treatment for Bell’s palsy: a multicenter, randomized, placebo-controlled study. Otol Neurotol 2007; 28(3): 408-413.
[29]	Lockhart P, Daly F, Pitkethly M, et al. Antiviral treatment for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2009; 7(4): CD001869.
[30]	Clinical Pharmacology [online database]. Tampa, FL: Gold Standard, Inc; 2010. www.clinicalpharmacology.com.
[31]	Fisch U, Esslen E. Total intratemporal exposure of the facial nerve: pathologic findings in Bell’s palsy. Arch Otolaryngol 1972;95: 335-41.
[32]	Gantz BJ, Rubinstein JT, Gidley P, Wood worth GG. Surgical management of Bell’s palsy. Laryngoscope 1999; 109: 1177-88.
[33]	May M, Klein SR, Taylor FH. Idiopathic (Bell’s) facial palsy: natural history defies steroid or surgical treatment. Laryngoscope 1985; 95: 406-9.
[34]	Bulstrode NW, Harrison DH. The phenomenon of the late recovered Bell's palsy: treatment options to improve facial symmetry. Plast Reconstr Surg. 2005; 115: 1466–1471.
[35]	Holland NJ, Weiner GM. Recent developments in Bell’s palsy. BMJ 2004; 329: 553-7.
[36]	Sullivan FM, Swan IR, Donnan PT Early treatmentwith prednisolone or acyclovir in Bell’s palsy. N Engl J Med 2007, 357: 1598-1607.