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

The grading system developed by House and Brackmann categorizes Bell palsy on a scale of I to VI. Grade I is normal facial function.

Grade II is mild dysfunction. Characteristics include the following:

• Slight weakness is noted on close inspection

• Slight synkinesis may be present

• Normal symmetry and tone are noted at rest

• Forehead motion is moderate to good

• Complete eye closure is achieved with minimal effort

• Slight mouth asymmetry is noted

Grade III is moderate dysfunction. The following characteristics are found:

• An obvious, but not disfiguring, difference is noted between the two sides

• A noticeable, but not severe, synkinesis, contracture, or hemifacial spasm is present

• Normal symmetry and tone are noted at rest

• Forehead movement is slight to moderate

• Complete eye closure is achieved with effort

• A slightly weak mouth movement is noted with maximal effort

Grade IV is moderately severe dysfunction. Signs include the following:

• Obvious weakness or disfiguring asymmetry is noted

• Symmetry and tone are normal at rest

• No forehead motion is observed

• Eye closure is incomplete

• An asymmetrical mouth is noted with maximal effort

Grade V is severe dysfunction. Characteristics include the following:

• Only barely perceptible motion is noted

• Asymmetry is noted at rest

• No forehead motion is observed

• Eye closure is incomplete

• Mouth movement is only slight

Grade VI is total paralysis. The following are noted:

• Gross asymmetry

• No movement

For more on the grading of Bell palsy, read here.

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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Selim Benbadis. Fast Five Quiz: How Much Do You Know About Bell Palsy? - Medscape - Sep 29, 2015.