bell palsy

Summary

Summary: A syndrome characterized by the acute onset of unilateral FACIAL PARALYSIS which progresses over a 2-5 day period. Weakness of the orbicularis oculi muscle and resulting incomplete eye closure may be associated with corneal injury. Pain behind the ear often precedes the onset of paralysis. This condition may be associated with HERPESVIRUS 1, HUMAN infection of the facial nerve. (Adams et al., Principles of Neurology, 6th ed, p1376)

Top Publications

  1. Xu S, Huang B, Zhang C, Du P, Yuan Q, Bi G, et al. Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial. CMAJ. 2013;185:473-9 pubmed publisher
    ..However, the notion that de qi must be achieved for maximum benefit has not been confirmed by modern scientific evidence...
  2. de Diego Sastre J, Prim Espada M, Fernández García F. [The epidemiology of Bell's palsy]. Rev Neurol. 2005;41:287-90 pubmed
    ..Bell's palsy (BP) is a frequent condition with an incidence that varies throughout different countries around the world. The aim of this article is to analyse the incidence of BP in different countries around the world...
  3. Gilden D, Tyler K. Bell's palsy--is glucocorticoid treatment enough?. N Engl J Med. 2007;357:1653-5 pubmed
  4. Kanaya K, Ushio M, Kondo K, Hagisawa M, Suzukawa K, Yamaguchi T, et al. Recovery of facial movement and facial synkinesis in Bell's palsy patients. Otol Neurotol. 2009;30:640-4 pubmed publisher
    ..We examined the relationship between the time course of development of facial synkinesis in patients with Bell's palsy and the severity of facial nerve damage...
  5. Gronseth G, Paduga R. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2012;79:2209-13 pubmed publisher
    To review evidence published since the 2001 American Academy of Neurology (AAN) practice parameter regarding the effectiveness, safety, and tolerability of steroids and antiviral agents for Bell palsy.
  6. Kim I, Shin S, Kim J, Lee W, Lee H. Correlation between MRI and operative findings in Bell's palsy and Ramsay Hunt syndrome. Yonsei Med J. 2007;48:963-8 pubmed
    ..To investigate the correlation between gadolinium enhanced magnetic resonance image (MRI) results and surgical findings of facial nerves in Bell's palsy and Ramsay Hunt syndrome...
  7. Hato N, Murakami S, Gyo K. Steroid and antiviral treatment for Bell's palsy. Lancet. 2008;371:1818-20 pubmed publisher
  8. Tong F, Chow S, Chan P, Wong A, Wan S, Ng R, et al. A prospective randomised controlled study on efficacies of acupuncture and steroid in treatment of idiopathic peripheral facial paralysis. Acupunct Med. 2009;27:169-73 pubmed publisher
    ..A randomised controlled trial was undertaken to evaluate the efficacy of acupuncture in comparison with steroid in treatment of idiopathic peripheral facial paralysis (Bell's palsy)...
  9. Kawaguchi K, Inamura H, Abe Y, Koshu H, Takashita E, Muraki Y, et al. Reactivation of herpes simplex virus type 1 and varicella-zoster virus and therapeutic effects of combination therapy with prednisolone and valacyclovir in patients with Bell's palsy. Laryngoscope. 2007;117:147-56 pubmed
    ..To determine whether reactivation of herpes simplex virus (HSV) type 1 or varicella-zoster virus (VZV) is the main cause of Bell's palsy and whether antiviral drugs bring about recovery from Bell's palsy...

More Information

Publications69

  1. de Almeida J, Al Khabori M, Guyatt G, Witterick I, Lin V, Nedzelski J, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis. JAMA. 2009;302:985-93 pubmed publisher
    New evidence has emerged regarding the use of corticosteroids and antiviral agents in Bell palsy.
  2. Vanopdenbosch L, Verhoeven K, Casselman J. Bell's palsy with ipsilateral numbness. J Neurol Neurosurg Psychiatry. 2005;76:1017-8 pubmed
    ..Magnetic resonance imaging showed had contrast enhancement in the greater petrosal nerve. Viral spread through anatomical connections could be an explanation for the association of facial palsy with numbness...
  3. Qu Y. [Clinical observation on acupuncture by stages combined with exercise therapy for treatment of Bell palsy at acute stage]. Zhongguo Zhen Jiu. 2005;25:545-7 pubmed
    To find out a method for increasing clinical therapeutic effect on Bell palsy at acute stage.
  4. Goudakos J, Markou K. Corticosteroids vs corticosteroids plus antiviral agents in the treatment of Bell palsy: a systematic review and meta-analysis. Arch Otolaryngol Head Neck Surg. 2009;135:558-64 pubmed publisher
    To review systematically and meta-analyze the results of all randomized controlled trials (RCTs) for the treatment of patients with Bell palsy with corticosteroids vs corticosteroids plus antiviral agents.
  5. Serrano P, Hernandez N, Arroyo J, de Llobet J, Domingo P. Bilateral Bell palsy and acute HIV type 1 infection: report of 2 cases and review. Clin Infect Dis. 2007;44:e57-61 pubmed
    Two adult patients who presented to a hospital with bilateral facial Bell palsy who were also experiencing human immunodeficiency virus type 1 seroconversion are described...
  6. Deng H, LE W, Hunter C, Mejia N, Xie W, Jankovic J. A family with Parkinson disease, essential tremor, bell palsy, and parkin mutations. Arch Neurol. 2007;64:421-4 pubmed
    ..Mutations in the parkin gene cause autosomal recessive early-onset Parkinson disease (EOPD). The A265G variant in the HS1 binding protein 3 gene (HS1BP3) is common in essential tremor (ET)...
  7. Zurbriggen R, Metcalfe I, Gluck R, Viret J, Moser C. Nonclinical safety evaluation of Escherichia coli heat-labile toxin mucosal adjuvant as a component of a nasal influenza vaccine. Expert Rev Vaccines. 2003;2:295-304 pubmed
    ..This review discusses the nonclinical safety evaluation of Escherichia coli heat-labile toxin as a mucosal adjuvant for an intranasally administered influenza vaccine...
  8. Savadi Oskouei D, Abedi A, Sadeghi Bazargani H. Independent role of hypertension in Bell's palsy: a case-control study. Eur Neurol. 2008;60:253-7 pubmed publisher
    ..In this case-control study, our aim was to check for a possible independent role of hypertension in increasing the risk of developing Bell's palsy...
  9. Zhao L, Zhang F, Li Y, Wu X, Zheng H, Cheng L, et al. Adverse events associated with acupuncture: three multicentre randomized controlled trials of 1968 cases in China. Trials. 2011;12:87 pubmed publisher
  10. Hato N, Yamada H, Kohno H, Matsumoto S, Honda N, Gyo K, et al. Valacyclovir and prednisolone treatment for Bell's palsy: a multicenter, randomized, placebo-controlled study. Otol Neurotol. 2007;28:408-13 pubmed
    ..To investigate the effects of valacyclovir and prednisolone in comparison with those of placebo and prednisolone for the treatment of Bell's palsy, excluding zoster sine herpete...
  11. Seok J, Lee D, Kim K. The usefulness of clinical findings in localising lesions in Bell's palsy: comparison with MRI. J Neurol Neurosurg Psychiatry. 2008;79:418-20 pubmed
    ..However, the accuracy of clinical findings in identifying lesions has never been evaluated...
  12. Minnerop M, Herbst M, Fimmers R, Kaabar P, Matz B, Klockgether T, et al. Bell's palsy: combined treatment of famciclovir and prednisone is superior to prednisone alone. J Neurol. 2008;255:1726-30 pubmed publisher
    ..7 % vs. 47.1 %; Cochran-Armitage trend test, p = 0.03). These results suggest that the combined treatment of famciclovir and prednisolone should be considered (at least) in patients with severe BP...
  13. Alberton D, Zed P. Bell's palsy: a review of treatment using antiviral agents. Ann Pharmacother. 2006;40:1838-42 pubmed
    ..To review the evidence evaluating the efficacy and safety of antiviral agents to reduce morbidity associated with Bell's palsy...
  14. Liang F, Li Y, Yu S, Li C, Hu L, Zhou D, et al. A multicentral randomized control study on clinical acupuncture treatment of Bell's palsy. J Tradit Chin Med. 2006;26:3-7 pubmed
    ..To confirm the clinical therapeutic effects of acupuncture and moxibustion on Bell's palsy...
  15. Khine H, Mayers M, Avner J, Fox A, Herold B, Goldman D. Association between herpes simplex virus-1 infection and idiopathic unilateral facial paralysis in children and adolescents. Pediatr Infect Dis J. 2008;27:468-9 pubmed publisher
    We studied the association between herpes simplex virus-1 (HSV-1) infection and Bell palsy in children. Thirty-three of 42 affected patients had a positive HSV-1 enzyme-linked immunosorbent assay compared with 16 of 41 controls (P = 0...
  16. Chen X, Li Y, Zheng H, Hu K, Zhang H, Zhao L, et al. A randomized controlled trial of acupuncture and moxibustion to treat Bell's palsy according to different stages: design and protocol. Contemp Clin Trials. 2009;30:347-53 pubmed publisher
    ..The result of this trial will certify the efficacy of using staging acupuncture and moxibustion to treat Bell's palsy, and to approach a best acupuncture treatment among these five different methods for treating Bell's palsy...
  17. Zhou W, Pool V, Destefano F, Iskander J, Haber P, Chen R. A potential signal of Bell's palsy after parenteral inactivated influenza vaccines: reports to the Vaccine Adverse Event Reporting System (VAERS)--United States, 1991-2001. Pharmacoepidemiol Drug Saf. 2004;13:505-10 pubmed
    ..We reviewed reports in the Vaccine Adverse Event Reporting System (VAERS) to assess if parenteral inactivated influenza vaccines (influenza vaccines) may also increase the risk for Bell's palsy...
  18. Quant E, Jeste S, Muni R, Cape A, Bhussar M, Peleg A. The benefits of steroids versus steroids plus antivirals for treatment of Bell's palsy: a meta-analysis. BMJ. 2009;339:b3354 pubmed publisher
    ..To determine whether steroids plus antivirals provide a better degree of facial muscle recovery in patients with Bell's palsy than steroids alone...
  19. Chow L, Tam R, Li M. Use of electroneurography as a prognostic indicator of Bell's palsy in Chinese patients. Otol Neurotol. 2002;23:598-601 pubmed
    ..To evaluate the use of electroneurography (ENOG) as a prognostic indicator in Bell's Palsy for Chinese patients in Hong Kong...
  20. Salinas R, Alvarez G, Daly F, Ferreira J. Corticosteroids for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2010;:CD001942 pubmed publisher
    ..Inflammation and oedema of the facial nerve are implicated in causing Bell's palsy. Corticosteroids have a potent anti-inflammatory action which should minimise nerve damage...
  21. Gilden D. Clinical practice. Bell's Palsy. N Engl J Med. 2004;351:1323-31 pubmed
  22. Linder T, Bossart W, Bodmer D. Bell's palsy and Herpes simplex virus: fact or mystery?. Otol Neurotol. 2005;26:109-13 pubmed
  23. Riga M, Kefalidis G, Danielides V. The role of diabetes mellitus in the clinical presentation and prognosis of Bell palsy. J Am Board Fam Med. 2012;25:819-26 pubmed publisher
    b>Bell palsy is considered to be an entrapment neuropathy resulting from inflammation, edema, and strangulation. Diabetes, hypertension, and hypercholesterolemia have all been related to microangiopathies...
  24. Rath B, Linder T, Cornblath D, Hudson M, Fernandopulle R, Hartmann K, et al. All that palsies is not Bell's -the need to define Bell's palsy as an adverse event following immunization. Vaccine. 2007;26:1-14 pubmed
  25. Zhao J, Piao Y, Wang J. Effect of acupuncture combined with blood-letting by a three-edged needle on 50 cases of Bell's palsy at the acute stage. J Tradit Chin Med. 2010;30:118-21 pubmed
    ..To observe clinical effects of acupuncture combined with blood-letting by a three-edged needle for treating Bell's palsy of wind-heat syndrome at the acute stage...
  26. Holland N, Weiner G. Recent developments in Bell's palsy. BMJ. 2004;329:553-7 pubmed
  27. Singhi P, Jain V. Bell's palsy in children. Semin Pediatr Neurol. 2003;10:289-97 pubmed
    ..A simple practical approach to diagnosing and treating children with Bell's palsy is suggested...
  28. Mutsch M, Zhou W, Rhodes P, Bopp M, Chen R, Linder T, et al. Use of the inactivated intranasal influenza vaccine and the risk of Bell's palsy in Switzerland. N Engl J Med. 2004;350:896-903 pubmed
    ..After the introduction of an inactivated intranasal influenza vaccine that was used only in Switzerland, 46 cases of Bell's palsy were reported...
  29. Piercy J. Bell's palsy. BMJ. 2005;330:1374 pubmed
  30. Hato N, Matsumoto S, Kisaki H, Takahashi H, Wakisaka H, Honda N, et al. Efficacy of early treatment of Bell's palsy with oral acyclovir and prednisolone. Otol Neurotol. 2003;24:948-51 pubmed
    ..To investigate the therapeutic effects of acyclovir and prednisolone in relation to the timing of treatment in Bell's palsy...
  31. Morris A, Deeks S, Hill M, Midroni G, Goldstein W, Mazzulli T, et al. Annualized incidence and spectrum of illness from an outbreak investigation of Bell's palsy. Neuroepidemiology. 2002;21:255-61 pubmed
    ..There are limited clinical and epidemiological data on patients diagnosed with Bell's palsy. While investigating an apparent clustering of Bell's palsy, we sought to characterize the spectrum of illness in patients with this diagnosis...
  32. Yeo S, Lee Y, Park D, Cha C. Acyclovir plus steroid vs steroid alone in the treatment of Bell's palsy. Am J Otolaryngol. 2008;29:163-6 pubmed publisher
    ..We therefore compared the therapeutic effect of acyclovir plus steroid vs steroid alone, in combination with physical therapy, in patients with Bell's palsy...
  33. Couch R. Nasal vaccination, Escherichia coli enterotoxin, and Bell's palsy. N Engl J Med. 2004;350:860-1 pubmed
  34. Sullivan F, Swan I, Donnan P, Morrison J, Smith B, McKinstry B, et al. Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med. 2007;357:1598-607 pubmed
    ..Corticosteroids and antiviral agents are widely used to treat the early stages of idiopathic facial paralysis (i.e., Bell's palsy), but their effectiveness is uncertain...
  35. Spengos K, Sameli S, Stouraitis G, Kolias A, Koulouri O, Kokkinos Z, et al. Seasonal variation of Bell's palsy in Athens, Greece - a hospital-based retrospective evaluation over fifteen years. Eur Neurol. 2006;55:84-8 pubmed
    ..Since a similar pathogenetic mechanism is regarded as the main cause of BP, the chronobiological aspects and the influence of meteorological factors on the reactivation of latent infections deserves further prospective evaluation...
  36. Engstrom M, Berg T, Stjernquist Desatnik A, Axelsson S, Pitkaranta A, Hultcrantz M, et al. Prednisolone and valaciclovir in Bell's palsy: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet Neurol. 2008;7:993-1000 pubmed publisher
    ..The aim of this study was to compare the short-term and long-term effects of prednisolone and valaciclovir in the recovery of the affected facial nerve in a large number of patients...
  37. Ahmed A. When is facial paralysis Bell palsy? Current diagnosis and treatment. Cleve Clin J Med. 2005;72:398-401, 405 pubmed
    b>Bell palsy is largely a diagnosis of exclusion, but certain features in the history and physical examination help distinguish it from facial paralysis due to other conditions: eg, abrupt onset with complete, unilateral facial weakness at ..
  38. Yanagihara N, Hato N, Murakami S, Honda N. Transmastoid decompression as a treatment of Bell palsy. Otolaryngol Head Neck Surg. 2001;124:282-6 pubmed
    ..We sought to assess the efficacy of transmastoid decompression after steroid treatment...
  39. Yanagihara N, Honda N, Hato N, Murakami S. Edematous swelling of the facial nerve in Bell's palsy. Acta Otolaryngol. 2000;120:667-71 pubmed
  40. Kinoshita T, Ishii K, Okitsu T, Okudera T, Ogawa T. Facial nerve palsy: evaluation by contrast-enhanced MR imaging. Clin Radiol. 2001;56:926-32 pubmed
    ..The purpose of this study was to investigate the value of contrast-enhanced magnetic resonance (MR) imaging in patients with peripheral facial nerve palsy...
  41. Furuta Y, Ohtani F, Chida E, Mesuda Y, Fukuda S, Inuyama Y. Herpes simplex virus type 1 reactivation and antiviral therapy in patients with acute peripheral facial palsy. Auris Nasus Larynx. 2001;28 Suppl:S13-7 pubmed
    ..The present study analyzed the severity of facial palsy in patients with HSV-1 reactivation and sought to determine the efficacy of acyclovir-prednisone therapy for these patients...
  42. Koriyama T, Inafuku S, Kimata K, Banno T, Ishigami H. Recent-onset bell palsy complicated by diabetes: comparison of steroid and lipoprostaglandin E(1) therapy. Arch Otolaryngol Head Neck Surg. 2001;127:1338-40 pubmed
    To compare megadose steroid therapy (n = 17; group S) and lipoprostaglandin E(1) (lipo-PGE(1)) therapy (n = 14; group L) in patients with recent-onset Bell palsy complicated by diabetes.
  43. Danielides V, Patrikakos G, Nousia C, Bartzokas A, Milionis H, Lolis C, et al. Weather conditions and Bell's palsy: five-year study and review of the literature. BMC Neurol. 2001;1:7 pubmed
  44. Rowlands S, Hooper R, Hughes R, Burney P. The epidemiology and treatment of Bell's palsy in the UK. Eur J Neurol. 2002;9:63-7 pubmed
    ..The majority of cases are treated expectantly without drugs. Lack of household clustering and lack of a tendency of herpes simplex infections to precede Bell's palsy do not support a viral aetiology...
  45. Grogan P, Gronseth G. 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;56:830-6 pubmed
    ..To determine the effectiveness of steroids, acyclovir, and surgical facial nerve decompression in Bell's palsy...
  46. Gillman G, Schaitkin B, May M, Klein S. Bell's palsy in pregnancy: a study of recovery outcomes. Otolaryngol Head Neck Surg. 2002;126:26-30 pubmed
    ..To study facial nerve recovery in patients with Bell's palsy of pregnancy compared with that of the nonpregnant population...
  47. Finn J. Botulinum toxin type A: fine-tuning treatment of facial nerve injury. J Drugs Dermatol. 2004;3:133-7 pubmed
    ..Careful use of botulinum toxin type A can be very useful in improving symmetry in acute or chronic facial nerve abnormality by treating the relatively hyperfunctional side. ..
  48. Grose C, Bonthius D, Afifi A. Chickenpox and the geniculate ganglion: facial nerve palsy, Ramsay Hunt syndrome and acyclovir treatment. Pediatr Infect Dis J. 2002;21:615-7 pubmed
    ..Retrospective reviews suggest that patients with VZV-related facial nerve palsy have poorer outcomes than other cases of Bell's palsy. Therefore treatment with acyclovir is suggested when VZV reactivation i slikely...
  49. Qi Q, Ni S, Wang Y, Peng K, Qu H, Yang C, et al. [Herbal acupoint sticking combined with electroacupuncture therapy in the treatment of Bell's palsy: a randomized controlled trial]. Zhongguo Zhen Jiu. 2013;33:965-9 pubmed
    ..05). Compared with EA, the combination of EA and acupoint sticking therapy for Bell's palsy cannot only improve the clinical efficacy and reduce the occurrence of complication but also reliable without any side effect. ..
  50. Vrabec J, Isaacson B, Van Hook J. Bell's palsy and pregnancy. Otolaryngol Head Neck Surg. 2007;137:858-61 pubmed
    ..Outcome may be poorer in pregnant patients, though historically, treatment is often withheld from these patients. Management of BP in pregnancy can mirror that of nonpregnant individuals with the exception of first-trimester cases. ..
  51. Shehata H, Okosun H. Neurological disorders in pregnancy. Curr Opin Obstet Gynecol. 2004;16:117-22 pubmed
    ..This paper reviews the current concepts and outlines appropriate management of conditions such as epilepsy, headache, benign intracranial hypertension, myasthenia gravis, multiple sclerosis, Bell's palsy and cerebrovascular disorders. ..
  52. Oishi N, Shinden S, Yamashita T, Minami S, Ogura M. [A clinical study of Bell's palsy and factors influencing its prognosis]. Nihon Jibiinkoka Gakkai Kaiho. 2007;110:592-8 pubmed
    ..101 and 1.586, respectively. Although this study had several limitations, steroid + antiviral treatment could yield a better prognosis as compared to steroid treatment alone. ..
  53. Song M, Kim J, Jeon J, Cho C, Yoo E, Lee W, et al. Clinical significance of quantitative analysis of facial nerve enhancement on MRI in Bell's palsy. Acta Otolaryngol. 2008;128:1259-65 pubmed publisher
    ..Signal intensity increase at the internal auditory canal and labyrinthine segments showed correlation with the initial degree of facial palsy but no significant difference was found between different prognostic groups. ..
  54. Guevara N, Santini J. [Decompression surgery for Bell's palsy: an evidence-based approach]. Rev Laryngol Otol Rhinol (Bord). 2008;129:309-11 pubmed
    ..Current practices are not standardised. Early medical therapy associating steroid drugs and antiviral agents after the onset of paralysis has become the gold standard. There is no evidence in favour of decompression surgery...
  55. Flodström A. [Bell palsy--evidence-based treatment?]. Lakartidningen. 2005;102:1361, 1363; author reply 1363 pubmed
  56. Hato N, Nota J, Komobuchi H, Teraoka M, Yamada H, Gyo K, et al. Facial nerve decompression surgery using bFGF-impregnated biodegradable gelatin hydrogel in patients with Bell palsy. Otolaryngol Head Neck Surg. 2012;146:641-6 pubmed publisher
    ..The aim of this study was to evaluate the regeneration-facilitating effects of novel facial nerve decompression surgery using bFGF in a gelatin hydrogel in patients with severe Bell palsy.
  57. Saini A, Singhi P, Sodhi K, Gupta A. Bell palsy in a neonate with rapid response to oral corticosteroids: a case report. J Child Neurol. 2013;28:506-8 pubmed publisher
    Idiopathic facial nerve palsy, also known as Bell palsy is rare in the neonatal age group. Other more common causes such as birth trauma; infections, especially otitis media; and congenital malformations need to be excluded...
  58. Watanabe T, Suzuki M. Equilibrium test findings in patients with Bell's palsy. Auris Nasus Larynx. 2006;33:143-7 pubmed
    ..We analyzed equilibrium test findings in patients with Bell's palsy to confirm that such findings occur not only in patients with Hunt's syndrome but also in patients with Bell's palsy...
  59. Fontana C, Bagnato V. Low-level laser therapy in pediatric Bell's palsy: case report in a three-year-old child. J Altern Complement Med. 2013;19:376-82 pubmed publisher
    ..The objective of this study was to apply low-level laser therapy (LLLT) to accelerate the recovery process of a child patient with Bell's palsy (BP)...
  60. Tiemstra J, Khatkhate N. Bell's palsy: diagnosis and management. Am Fam Physician. 2007;76:997-1002 pubmed