Bell's palsy natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
The onset of [[Bell's palsy (patient information)|Bell's palsy]] is sudden and [[Symptoms|symptom]]<nowiki/>s typically peak fast, within a few days. The main [[symptom]] is acute peripheral [[facial weakness]]. The [[hallmark]] of [[Bell's palsy (patient information)|Bell's palsy]] is unilateral, acute [[Paresis|paresis or paralysis]] of facial movement. A positive history of [[viral infections]], Ischemic [[mononeuropathy]],[[Diabetes mellitus]] and [[Thyroid]] disorders is suggestive of Bell's palsy. Patients with [[Bell's palsy CT|Bell's palsy]] may also have a positive history of: [[Herpes simplex virus]] reactivation, [[Herpes Zoster]], [[Cytomegalovirus]], [[Epstein Barr virus]], r[[Rubella|ubella]] virus, [[Mumps]], i[[Influenza B|nfluenza B]], [[Coxsackievirus|coxsackie virus]], [[Rickettsia conorii|rickettsial]] infection, [[Borrelia burgdorferi]], acute [[HIV]] infection, [[ischemic]] [[mononeuropathy]], [[Diabetes mellitus]] and [[Thyroid-hormone transaminase|Thyroid]] disorders. Complications of [[B&K Universal|Bell’s palsy]] include: incomplete [[eyelid]] closure with resultant dry [[eye]], permanent [[facial weakness]] with [[muscle]] [[contractures]], motor [[synkinesis]] , crocodile tears (tears when eating due to misdirection of regenerating [[gustatory]] [[Fibre|fibres]] destined for the [[Salivary gland|salivary glands]], so that they become [[Secretory component|secretory]] [[Fiber|fibre]]<nowiki/>s to the [[lacrimal gland]] and cause [[ipsilateral]] tearing while the patient is eating), contracture of [[facial muscles]], reduction or loss of taste [[sensation]] and problems with [[dysarthria]] due to facial [[muscle weakness]]. [[Prognosis]] of [[Bell's palsy CT|Bell's palsy]] is generally good. If left untreated approximately 71% of patients with Bell's palsy recover normal function and around 13% are left with slight weakness and around 4% with severe weakness resulting in major [[facial]] dysfunction. The presence of complete [[palsy]], advanced age and [[Herpes zoster Infection|Herpes zoster infection]] is associated with a particularly poor prognosis among patients with [[Bell's palsy (patient information)|Bell's palsy]]. The [[Bell's palsy (patient information)|Bell's palsy]] recurs in 7% of patients. The [[House dust mite|House-Brackmann]] grading system was devised both as a clinical indicator of severity and also an objective record of progress.


OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==


===Natural History===
===Natural History===
*The onset of Bell's palsy is sudden and symptoms typically peak fast, within a few days and include:<ref name="pmid21847333">{{cite journal| author=Murthy JM, Saxena AB| title=Bell's palsy: Treatment guidelines. | journal=Ann Indian Acad Neurol | year= 2011 | volume= 14 | issue= Suppl 1 | pages= S70-2 | pmid=21847333 | doi=10.4103/0972-2327.83092 | pmc=3152161 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21847333  }} </ref><ref name="pmid5573820">{{cite journal| author=Hauser WA, Karnes WE, Annis J, Kurland LT| title=Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. | journal=Mayo Clin Proc | year= 1971 | volume= 46 | issue= 4 | pages= 258-64 | pmid=5573820 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5573820  }} </ref>
*The onset of [[Bead theory|Bell's palsy]] is sudden and symptoms typically peak fast, within a few days.<ref name="pmid21847333">{{cite journal| author=Murthy JM, Saxena AB| title=Bell's palsy: Treatment guidelines. | journal=Ann Indian Acad Neurol | year= 2011 | volume= 14 | issue= Suppl 1 | pages= S70-2 | pmid=21847333 | doi=10.4103/0972-2327.83092 | pmc=3152161 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21847333  }} </ref><ref name="pmid5573820">{{cite journal| author=Hauser WA, Karnes WE, Annis J, Kurland LT| title=Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. | journal=Mayo Clin Proc | year= 1971 | volume= 46 | issue= 4 | pages= 258-64 | pmid=5573820 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5573820  }} </ref>
*the main symptom is acute peripheral [[facial weakness]].  
*the main symptom is acute peripheral [[facial weakness]].  
*Additional symptoms may include:
*The [[hallmark]] of [[Bell's palsy (patient information)|Bell's palsy]] is unilateral, acute [[paresis]] or [[paralysis]] of facial movement. A positive history of [[viral infections]][[Isaac Chayyim Cantarini|, Ischemic]] [[mononeuropathy]],[[Diabetes mellitus]] and [[Thyroid-hormone transaminase|Thyroid disorders]] is suggestive of [[Bell's palsy (patient information)|Bell's palsy]].
**Pain in or behind the ear
**[[Numbness]] or [[tingling]] in the affected side of the face usually without any objective deficit on [[neurological examination]]  
**[[Hyperacusis]] and [[Taste alteration|disturbed taste]] on the [[ipsilateral]] anterior part of the [[tongue]]  


Patients with [[Bell's palsy (patient information)|Bell's palsy]] may have a positive history of:
* [[Viral infections|Viral infections:]]
**[[Herpes simplex virus]] reactivation<ref name="pmid9515763">{{cite journal| author=Furuta Y, Fukuda S, Chida E, Takasu T, Ohtani F, Inuyama Y et al.| title=Reactivation of herpes simplex virus type 1 in patients with Bell's palsy. | journal=J Med Virol | year= 1998 | volume= 54 | issue= 3 | pages= 162-6 | pmid=9515763 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9515763  }} </ref>
**[[Herpes Zoster]]<ref name="pmid11096766">{{cite journal| author=Morrow MJ| title=Bell's Palsy and Herpes Zoster Oticus. | journal=Curr Treat Options Neurol | year= 2000 | volume= 2 | issue= 5 | pages= 407-416 | pmid=11096766 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11096766  }} </ref>
**[[Cytomegalovirus]]<ref name="pmid6327983">{{cite journal| author=Walters BN, Redman CW| title=Bell's palsy and cytomegalovirus mononucleosis in pregnancy. | journal=J R Soc Med | year= 1984 | volume= 77 | issue= 5 | pages= 429-30 | pmid=6327983 | doi= | pmc=1439928 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6327983  }} </ref>
**[[Epstein Barr virus]]<ref name="pmid10365586">{{cite journal| author=Maeda S, Tsuda H, Haruki S, Mitsuto I| title=Atypical Epstein-Barr virus infection associated with Gianotti-Crosti syndrome and Bell's palsy. | journal=Pediatr Int | year= 1999 | volume= 41 | issue= 3 | pages= 315-7 | pmid=10365586 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10365586  }} </ref>
**[[Rubella]] virus<ref name="pmid6886708">{{cite journal| author=Jamal GA, Al-Husaini A| title=Bell's palsy and infection with rubella virus. | journal=J Neurol Neurosurg Psychiatry | year= 1983 | volume= 46 | issue= 7 | pages= 678-80 | pmid=6886708 | doi= | pmc=1027493 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6886708  }} </ref>
**[[Mumps]]<ref name="pmid24653846">{{cite journal| author=Kondo K, Kanaya K, Baba S, Yamasoba T| title=Mumps, cervical zoster, and facial paralysis: coincidence or association? | journal=Case Rep Otolaryngol | year= 2014 | volume= 2014 | issue=  | pages= 289687 | pmid=24653846 | doi=10.1155/2014/289687 | pmc=3933221 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24653846  }} </ref>
**[[Influenza B]]<ref name="pmid28467420">{{cite journal| author=Wijnans L, Dodd CN, Weibel D, Sturkenboom M| title=Bell's palsy and influenza(H1N1)pdm09 containing vaccines: A self-controlled case series. | journal=PLoS One | year= 2017 | volume= 12 | issue= 5 | pages= e0175539 | pmid=28467420 | doi=10.1371/journal.pone.0175539 | pmc=5414992 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28467420  }} </ref>
**[[Coxsackievirus]]<ref name="pmid19561942">{{cite journal| author=McFarlin A, Peckler B| title=An unusual presentation of Bell's palsy: A case report and review of literature. | journal=J Emerg Trauma Shock | year= 2008 | volume= 1 | issue= 1 | pages= 50-2 | pmid=19561942 | doi=10.4103/0974-2700.40574 | pmc=2700557 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19561942  }} </ref>
**[[Rickettsia|Rickettsial]] infection <ref name="pmid11420202">{{cite journal| author=Bitsori M, Galanakis E, Papadakis CE, Sbyrakis S| title=Facial nerve palsy associated with Rickettsia conorii infection. | journal=Arch Dis Child | year= 2001 | volume= 85 | issue= 1 | pages= 54-5 | pmid=11420202 | doi= | pmc=1718833 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11420202  }} </ref>
**[[Borrelia burgdorferi]]<ref name="pmid3912092">{{cite journal| author=Schmutzhard E, Stanek G| title=Borrelia burgdorferi, a possible cause of Bell's palsy? | journal=Clin Neurol Neurosurg | year= 1985 | volume= 87 | issue= 4 | pages= 255-7 | pmid=3912092 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3912092  }} </ref>
**Acute [[HIV]] infection<ref name="pmid3361335">{{cite journal| author=Brown MM, Thompson A, Goh BT, Forster GE, Swash M| title=Bell's palsy and HIV infection. | journal=J Neurol Neurosurg Psychiatry | year= 1988 | volume= 51 | issue= 3 | pages= 425-6 | pmid=3361335 | doi= | pmc=1032872 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3361335  }} </ref>
*Ischemic [[mononeuropathy]]<ref name="pmid23891413">{{cite journal| author=Fahimi J, Navi BB, Kamel H| title=Potential misdiagnoses of Bell's palsy in the emergency department. | journal=Ann Emerg Med | year= 2014 | volume= 63 | issue= 4 | pages= 428-34 | pmid=23891413 | doi=10.1016/j.annemergmed.2013.06.022 | pmc=3940662 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23891413  }} </ref>
*[[Diabetes mellitus]]<ref name="pmid7119834">{{cite journal| author=Pecket P, Schattner A| title=Concurrent Bell's palsy and diabetes mellitus: a diabetic mononeuropathy? | journal=J Neurol Neurosurg Psychiatry | year= 1982 | volume= 45 | issue= 7 | pages= 652-5 | pmid=7119834 | doi= | pmc=491483 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7119834  }} </ref>
*[[Thyroid-hormone transaminase|Thyroid disorders]]<ref name="pmid4015946">{{cite journal| author=Cox NH, Chew D, Williams JG, Morris AI| title=Bell's Palsy associated with hypothyroidism. | journal=Br J Clin Pract | year= 1985 | volume= 39 | issue= 4 | pages= 158-9 | pmid=4015946 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4015946  }} </ref>
===Complications===
===Complications===
*Complications of Bell’s palsy include:<ref name="pmid17956069">{{cite journal| author=Tiemstra JD, Khatkhate N| title=Bell's palsy: diagnosis and management. | journal=Am Fam Physician | year= 2007 | volume= 76 | issue= 7 | pages= 997-1002 | pmid=17956069 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17956069  }} </ref><ref name="pmid28798513">{{cite journal| author=Somasundara D, Sullivan F| title=Management of Bell's palsy. | journal=Aust Prescr | year= 2017 | volume= 40 | issue= 3 | pages= 94-97 | pmid=28798513 | doi=10.18773/austprescr.2017.030 | pmc=5478391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28798513  }} </ref>
*Complications of [[Bell's palsy CT scan|Bell’s palsy]] include:<ref name="pmid17956069">{{cite journal| author=Tiemstra JD, Khatkhate N| title=Bell's palsy: diagnosis and management. | journal=Am Fam Physician | year= 2007 | volume= 76 | issue= 7 | pages= 997-1002 | pmid=17956069 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17956069  }} </ref><ref name="pmid28798513">{{cite journal| author=Somasundara D, Sullivan F| title=Management of Bell's palsy. | journal=Aust Prescr | year= 2017 | volume= 40 | issue= 3 | pages= 94-97 | pmid=28798513 | doi=10.18773/austprescr.2017.030 | pmc=5478391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28798513  }} </ref>
** Incomplete eyelid closure with resultant dry eye
** Incomplete [[eyelid]] closure with resultant [[Eye-eating amoeba|dry eye]]
** Permanent facial weakness with muscle contractures
** Permanent [[facial weakness]] with [[muscle]] [[contractures]]
** Motor synkinesis (involuntary movement of muscles occurring at the same time as deliberate movement, e.g. involuntary mouth movement during voluntary eye closure)
** Motor [[synkinesis]] (involuntary movement of muscles occurring at the same time as deliberate movement, e.g. involuntary mouth movement during voluntary eye closure)
** Crocodile tears (tears when eating due to misdirection of regenerating gustatory fibres destined for the salivary glands, so that they become secretory fibres to the lacrimal gland and cause ipsilateral tearing while the patient is eating)
**[[Crocin|Crocodile tears]] (tears when eating due to misdirection of regenerating [[gustatory]] [[Fiber|fibres]] destined for the [[Salivary gland|salivary glands]], so that they become [[Secretory component|secretory]] [[Fiber|fibre]]<nowiki/>s to the [[lacrimal gland]] and cause [[ipsilateral]] tearing while the patient is eating)
** Incomplete recovery
** Incomplete recovery
** Contracture of facial muscles
** Contracture of [[facial muscles]]
** Reduction or loss of taste sensation
** Reduction or loss of taste [[sensation]]
** Problems with dysarthria due to facial muscle weakness
** Problems with [[dysarthria]] due to facial [[muscle weakness]]
 
 
===Prognosis===
===Prognosis===
*Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
*Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
*[Subtype of disease/malignancy] is associated with the most favorable prognosis.
*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
==Natural History, Complications and Prognosis==


:*The House-Brackmann grading system was devised both as a clinical indicator of severity and also an objective record of progress.  
*[[Prognosis]] of [[Bell's palsy CT|Bell's palsy]] is generally good.<ref name="pmid13768298">{{cite journal| author=MATTHEWS WB| title=Prognosis in Bell's palsy. | journal=Br Med J | year= 1961 | volume= 2 | issue= 5246 | pages= 215-7 | pmid=13768298 | doi= | pmc=1969111 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13768298  }} </ref>
:*Clinically incomplete lesions tend to recover.  
*If left untreated approximately 71% of patients with [[Bell's palsy (patient information)|Bell's palsy]] recover normal function and around 13% are left with slight weakness and around 4% with severe weakness resulting in major [[facial]] dysfunction.<ref name="pmid28798513">{{cite journal| author=Somasundara D, Sullivan F| title=Management of Bell's palsy. | journal=Aust Prescr | year= 2017 | volume= 40 | issue= 3 | pages= 94-97 | pmid=28798513 | doi=10.18773/austprescr.2017.030 | pmc=5478391 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28798513  }} </ref>
:*The natural history without treatment was described in a study of 1011 patients in 1982:
*The presence of complete [[palsy]], advanced age and [[Herpes zoster Infection|Herpes zoster infection]] is associated with a particularly poor prognosis among patients with [[Bell's palsy CT|Bell's palsy]].<ref name="pmid13768298">{{cite journal| author=MATTHEWS WB| title=Prognosis in Bell's palsy. | journal=Br Med J | year= 1961 | volume= 2 | issue= 5246 | pages= 215-7 | pmid=13768298 | doi= | pmc=1969111 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13768298  }} </ref>
::*67% had incomplete paralysis, with 94% rate of return to normal function
*The [[Bell's palsy (patient information)|Bell's palsy]] recurs in 7% of patients.<ref name="pmid13768298" />
::*33% had complete [[paralysis]], with 60% rate of return to normal function
*The [[House Ear Institute|House-Brackmann]] grading system was devised both as a clinical indicator of severity and also an objective record of progress.<ref name="pmid19201280">{{cite journal| author=Reitzen SD, Babb JS, Lalwani AK| title=Significance and reliability of the House-Brackmann grading system for regional facial nerve function. | journal=Otolaryngol Head Neck Surg | year= 2009 | volume= 140 | issue= 2 | pages= 154-8 | pmid=19201280 | doi=10.1016/j.otohns.2008.11.021 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19201280  }} </ref>
::*By 3 weeks, 71% had complete recovery, 13% had slight sequelae , and 16% had residual weakness
:*Herpes zoster is associated with more severe [[paresis]] and worse prognosis compared with "idiopathic" Bell's palsy.  
:*There is a favorable prognosis if some recovery is seen within the first 21 days of onset.  
:*In severe lesions that recover, the outgrowth of new axons from the injury site may be disorganized and misdirected.
:*On blinking there is twitching of the angle of the mouth, and on smiling the eye may close or wink.  
:*With misdirected autonomic fibers, a salivary stimulus may result in excess [[lacrimation]], the syndrome of "crocodile tears."
:*Recurrent attacks on either the ipsilateral or contralateral side have been observed in 7 to 15% of patients.


==References==
==References==

Latest revision as of 14:13, 8 April 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

The onset of Bell's palsy is sudden and symptoms typically peak fast, within a few days. The main symptom is acute peripheral facial weakness. The hallmark of Bell's palsy is unilateral, acute paresis or paralysis of facial movement. A positive history of viral infections, Ischemic mononeuropathy,Diabetes mellitus and Thyroid disorders is suggestive of Bell's palsy. Patients with Bell's palsy may also have a positive history of: Herpes simplex virus reactivation, Herpes Zoster, Cytomegalovirus, Epstein Barr virus, rubella virus, Mumps, influenza B, coxsackie virus, rickettsial infection, Borrelia burgdorferi, acute HIV infection, ischemic mononeuropathy, Diabetes mellitus and Thyroid disorders. Complications of Bell’s palsy include: incomplete eyelid closure with resultant dry eye, permanent facial weakness with muscle contractures, motor synkinesis , crocodile tears (tears when eating due to misdirection of regenerating gustatory fibres destined for the salivary glands, so that they become secretory fibres to the lacrimal gland and cause ipsilateral tearing while the patient is eating), contracture of facial muscles, reduction or loss of taste sensation and problems with dysarthria due to facial muscle weakness. Prognosis of Bell's palsy is generally good. If left untreated approximately 71% of patients with Bell's palsy recover normal function and around 13% are left with slight weakness and around 4% with severe weakness resulting in major facial dysfunction. The presence of complete palsy, advanced age and Herpes zoster infection is associated with a particularly poor prognosis among patients with Bell's palsy. The Bell's palsy recurs in 7% of patients. The House-Brackmann grading system was devised both as a clinical indicator of severity and also an objective record of progress.

Natural History, Complications, and Prognosis

Natural History

Patients with Bell's palsy may have a positive history of:

Complications

Prognosis

References

  1. ↑ Murthy JM, Saxena AB (2011). "Bell's palsy: Treatment guidelines". Ann Indian Acad Neurol. 14 (Suppl 1): S70–2. doi:10.4103/0972-2327.83092. PMC 3152161. PMID 21847333.
  2. ↑ Hauser WA, Karnes WE, Annis J, Kurland LT (1971). "Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota". Mayo Clin Proc. 46 (4): 258–64. PMID 5573820.
  3. ↑ Furuta Y, Fukuda S, Chida E, Takasu T, Ohtani F, Inuyama Y; et al. (1998). "Reactivation of herpes simplex virus type 1 in patients with Bell's palsy". J Med Virol. 54 (3): 162–6. PMID 9515763.
  4. ↑ Morrow MJ (2000). "Bell's Palsy and Herpes Zoster Oticus". Curr Treat Options Neurol. 2 (5): 407–416. PMID 11096766.
  5. ↑ Walters BN, Redman CW (1984). "Bell's palsy and cytomegalovirus mononucleosis in pregnancy". J R Soc Med. 77 (5): 429–30. PMC 1439928. PMID 6327983.
  6. ↑ Maeda S, Tsuda H, Haruki S, Mitsuto I (1999). "Atypical Epstein-Barr virus infection associated with Gianotti-Crosti syndrome and Bell's palsy". Pediatr Int. 41 (3): 315–7. PMID 10365586.
  7. ↑ Jamal GA, Al-Husaini A (1983). "Bell's palsy and infection with rubella virus". J Neurol Neurosurg Psychiatry. 46 (7): 678–80. PMC 1027493. PMID 6886708.
  8. ↑ Kondo K, Kanaya K, Baba S, Yamasoba T (2014). "Mumps, cervical zoster, and facial paralysis: coincidence or association?". Case Rep Otolaryngol. 2014: 289687. doi:10.1155/2014/289687. PMC 3933221. PMID 24653846.
  9. ↑ Wijnans L, Dodd CN, Weibel D, Sturkenboom M (2017). "Bell's palsy and influenza(H1N1)pdm09 containing vaccines: A self-controlled case series". PLoS One. 12 (5): e0175539. doi:10.1371/journal.pone.0175539. PMC 5414992. PMID 28467420.
  10. ↑ McFarlin A, Peckler B (2008). "An unusual presentation of Bell's palsy: A case report and review of literature". J Emerg Trauma Shock. 1 (1): 50–2. doi:10.4103/0974-2700.40574. PMC 2700557. PMID 19561942.
  11. ↑ Bitsori M, Galanakis E, Papadakis CE, Sbyrakis S (2001). "Facial nerve palsy associated with Rickettsia conorii infection". Arch Dis Child. 85 (1): 54–5. PMC 1718833. PMID 11420202.
  12. ↑ Schmutzhard E, Stanek G (1985). "Borrelia burgdorferi, a possible cause of Bell's palsy?". Clin Neurol Neurosurg. 87 (4): 255–7. PMID 3912092.
  13. ↑ Brown MM, Thompson A, Goh BT, Forster GE, Swash M (1988). "Bell's palsy and HIV infection". J Neurol Neurosurg Psychiatry. 51 (3): 425–6. PMC 1032872. PMID 3361335.
  14. ↑ Fahimi J, Navi BB, Kamel H (2014). "Potential misdiagnoses of Bell's palsy in the emergency department". Ann Emerg Med. 63 (4): 428–34. doi:10.1016/j.annemergmed.2013.06.022. PMC 3940662. PMID 23891413.
  15. ↑ Pecket P, Schattner A (1982). "Concurrent Bell's palsy and diabetes mellitus: a diabetic mononeuropathy?". J Neurol Neurosurg Psychiatry. 45 (7): 652–5. PMC 491483. PMID 7119834.
  16. ↑ Cox NH, Chew D, Williams JG, Morris AI (1985). "Bell's Palsy associated with hypothyroidism". Br J Clin Pract. 39 (4): 158–9. PMID 4015946.
  17. ↑ Tiemstra JD, Khatkhate N (2007). "Bell's palsy: diagnosis and management". Am Fam Physician. 76 (7): 997–1002. PMID 17956069.
  18. ↑ 18.0 18.1 Somasundara D, Sullivan F (2017). "Management of Bell's palsy". Aust Prescr. 40 (3): 94–97. doi:10.18773/austprescr.2017.030. PMC 5478391. PMID 28798513.
  19. ↑ 19.0 19.1 19.2 MATTHEWS WB (1961). "Prognosis in Bell's palsy". Br Med J. 2 (5246): 215–7. PMC 1969111. PMID 13768298.
  20. ↑ Reitzen SD, Babb JS, Lalwani AK (2009). "Significance and reliability of the House-Brackmann grading system for regional facial nerve function". Otolaryngol Head Neck Surg. 140 (2): 154–8. doi:10.1016/j.otohns.2008.11.021. PMID 19201280.

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