Approach to Bell’s paralysis: diagnosis and treatment

Abstract

Bell’s palsy or peripheral facial paralysis is a neuromuscular disease with direct involvement of the facial nerve. It is a common pathology with presentation peaks at 20 to 29 years and 50 to 59 years. Although it is idiopathic, the herpes simplex virus is the main cause of suspicion. It is shown as a sudden unilateral facial paralysis with subsequent worsening. It presents symptoms such as muscular and sensitive nervous affectation like difficulty to raise the eyebrow, to close the eyes, to smile, to frown, facial paresthesias, hyperacusis, among others. Its diagnosis is mainly clinical, but other complementary diagnostic methods are also used to rule out various pathologies. It is necessary a prompt and timely management to achieve complete remission and avoid complications, this includes oral corticosteroids, assess the use of antivirals and an adequate eye protection. Most patients manifest spontaneous remission with a complete recovery, those who show an incomplete recovery can benefit from physical therapies to improve facial function and the prevention of sequelae such as hypertonicity, facial asymmetry and synkinesis.