Fast Five Quiz: Bell Palsy Essentials

Helmi L. Lutsep, MD

Disclosures

February 06, 2019

According to American Academy of Otolaryngology-Head and Neck Surgery guidelines, clinicians should prescribe oral steroids within 72 hours of symptom onset for all patients with Bell palsy who are aged 16 years and older. These guidelines also suggest that clinicians should not prescribe oral antiviral therapy alone for patients with new-onset Bell palsy. However, oral antiviral therapy may be offered in addition to oral steroids within 72 hours of symptom onset.

Surgery may be considered in patients with complete Bell palsy that has not responded to medical therapy and with greater than 90% axonal degeneration, as shown on facial nerve EMG within 3 weeks of the onset of paralysis.

In most cases, topical ocular lubrication (with artificial tears during the day and lubricating ophthalmic ointment at night, or occasionally ointment day and night) is sufficient to prevent the complications of corneal exposure. Punctal plugs may be helpful if dryness of the cornea is a persistent problem.

Read more about the treatment of Bell palsy.

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