Bell's palsy Podcast: Diagnosis and Patient Counseling
This podcast highlights a Clinical Practice Guideline on Bell’s Palsy appearing as a November 2013 supplement in Otolaryngology - Head and Neck Surgery, the official journal of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) Foundation. Editor in chief Richard Rosenfeld is joined by authors John Halperin, a neurologist, and Kaparaboyna Ashok Kumar, a family physician, in discussing aspects of the guideline related to diagnosis and patient counseling.
Description
Bell’s palsy is a rapid (less than 72 hours) unilateral facial nerve paresis (weakness) or paralysis (complete loss of movement) of unknown cause, which leads to partial or complete inability to voluntarily move facial muscles on the affected side. This clinical practice guideline includes 11 recommended actions, intended to improve, quality of care, which were developed by a multidisciplinary panel representing the fields of otolaryngology, neurology, facial plastic and reconstructive surgery, neurotology, emergency medicine, primary care, otology, nursing, physician assistants, and consumer advocacy. Patient history and physical examination are emphasized to exclude identifiable causes of facial paresis. The guideline recommends that clinicians should not obtain routine laboratory testing, or routinely perform diagnostic imaging, in patients with new onset Bell’s palsy. The importance of early measures for eye protection are stressed. Electrodiagnostic testing is not recommended for paresis (weakness), but may be offered to patients with complete facial paralysis to gain prognostic information. Clinicians should reassess or refer to a facial nerve specialist those Bell’s palsy patients with (a) new or worsening neurologic findings at any point, (2) ocular symptoms developing at any point, or (3) incomplete facial recovery 3 months after initial symptom onset.
