Fast Five Quiz: How Much Do You Know About Bell Palsy?

Selim Benbadis, MD


September 29, 2015

Early ocular complications include the following:

  • Lagophthalmos (inability to close the eye completely)

  • Paralytic ectropion of the lower lid

  • Corneal exposure

  • Brow droop

  • Upper eyelid retraction

  • Decreased tear output and poor tear distribution

  • Loss of the nasolabial fold

  • Corneal erosion, infection, and ulceration (rare)

Late ocular manifestations include the following:

  • Mild, generalized mass contracture of the facial muscles, rendering the affected palpebral fissure narrower than the opposite one (after several months)

  • Aberrant regeneration of the facial nerve with motor synkinesis

  • Reversed jaw winking (ie, contracture of the facial muscles with twitching of the corner of the mouth or dimpling of the chin occurring simultaneously with each blink)

  • Autonomic synkinesis (ie, crocodile tears—tearing with chewing)

  • Permanent, disfiguring facial paralysis (rare)

For more on presentation of Bell palsy, read here.


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