The Diagnosis and Treatment of Idiopathic Facial Paresis (Bell’s Palsy)

Heckmann, Josef G.; Urbán, Péter; Pitz, Susanne; Guntinas‐Lichius, Orlando; Gágyor, Ildikó

doi:10.3238/arztebl.2019.0692

Cited by 111 publications

(117 citation statements)

References 70 publications

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“…Patients with incomplete paresis have good prognosis. In contrast, the German and the Spanish guidelines recommend electrodiagnostics for all patients with Bell's palsy [17][18][19]. Some recommend electrodiagnostics for all patients with facial nerve disorder.…”

Section: Electrophysiological Diagnostic Evaluationmentioning

confidence: 99%

Facial nerve electrodiagnostics for patients with facial palsy: a clinical practice guideline

Guntinas‐Lichius

Volk

Olsen

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose Facial nerve electrodiagnostics is a well-established and important tool for decision making in patients with facial nerve diseases. Nevertheless, many otorhinolaryngologist-head and neck surgeons do not routinely use facial nerve electrodiagnostics. This may be due to a current lack of agreement on methodology, interpretation, validity, and clinical application. Electrophysiological analyses of the facial nerve and the mimic muscles can assist in diagnosis, assess the lesion severity, and aid in decision making. With acute facial palsy, it is a valuable tool for predicting recovery. Methods This paper presents a guideline prepared by members of the International Head and Neck Scientific Group and of the Multidisciplinary Salivary Gland Society for use in cases of peripheral facial nerve disorders based on a systematic literature search. Results Required equipment, practical implementation, and interpretation of the results of facial nerve electrodiagnostics are presented. Conclusion The aim of this guideline is to inform all involved parties (i.e. otorhinolaryngologist-head and neck surgeons and other medical specialists, therapeutic professionals and the affected persons) and to provide practical recommendations for the diagnostic use of facial nerve electrodiagnostics.

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Section: Electrophysiological Diagnostic Evaluationmentioning

confidence: 99%

Facial nerve electrodiagnostics for patients with facial palsy: a clinical practice guideline

Guntinas‐Lichius

Volk

Olsen

et al. 2020

Eur Arch Otorhinolaryngol

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“…Idiopathic facial paralysis (also called Bell's palsy) is a peripheral paralysis of the facial nerve of unknown origin, and the most common cause of facial nerve paralysis [4]. Current treatment options include corticosteroids (which have been shown to significantly improve motor recovery [8]), possibly associated with virostatic agents.…”

Section: Commentarymentioning

confidence: 99%

“…From a pathophysiological standpoint, it has been suggested that facial nerve paralysis could result from the reactivation of herpes simplex virus type 1 (HSV-1) infection within the facial nerve [2,3,11] and that as such, episodes of facial paralysis could be provoked by stress (or trauma, e.g. following dental treatment [11]), in analogy to herpes labialis [4]. The present case gives credence to such theory, as idiopathic facial paralysis occurred concurrently with a major anxiety episode secondary to COVID-19-related lockdown and subsequent socio-economical repercussions.…”

Section: Commentarymentioning

confidence: 99%

“…We report a case of a healthy 49-year-old French chef, who suffered from right idiopathic facial paralysis (Bell's Palsy) in a context of severe lockdown-related anxiety (stemming mainly from concerns regarding his professional prospects). As such facial paralysis is considered secondary to reactivation of Herpes Simplex Virus 1 (HSV-1) in the facial nerve [2,3] and in analogy with stress-related herpes labialis outbreaks [4] this case could constitute a lockdown-related (or favored) illness, an illustration of the indirect medical impact of the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

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Lockdown-related idiopathic facial paralysis: illustration of an indirect victim of the COVID-19 pandemic?

Fricain

Moreau

2020

J Oral Med Oral Surg

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Introduction: In the midst of the COVID-19 pandemic, there are numerous reports of SARS-CoV-2-related symptoms in many medical subspecialties. Unfortunately, there seems to be little focus on indirect victims of COVID-19, such as diseases/ailments secondary to COVID-19-related lockdown in relevant countries. Observation: We report a case of idiopathic facial paralysis (Bell's Palsy) that occurred in an otherwise-healthy 49-year-old French chef during nationwide lockdown, possibly fostered by severe concerns regarding his professional prospects. Other manifestations of severe anxiety were also observed such as tension-type headache and psoriasis outbreaks. Prednisone and valaciclovir were initiated, in association with simple counselling. Commentary and conclusion: As HSV-1 reactivation in the facial nerve is suspected in the pathophysiology of idiopathic facial paralysis, this case could constitute an example of lockdown-related disease and an illustration of indirect manifestations of the COVID-19 pandemic. Such indirect diseases are likely to increase as the pandemic continues to take its toll both medically and socio-economically.

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“…There may also be decreased tearing, hyperacusis, and/or loss of taste sensation on the anterior two thirds of the tongue. 10 The nerve paralysis was named after Scottish physician, surgeon, and neurologist Charles Bell (1774-1842) who first described the lesions of facial nerve (CN VII) and its clinical presentations. 11 It has been widely accepted that herpes simplex virus and herpes zoster virus are the most common etiology of Bell's palsy.…”

mentioning

confidence: 99%

New onset of Bell’s palsy in a patient with West Nile Encephalitis

Vaysman

Melkonyan

Liu

2020

Clinical Case Reports

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West Nile virus (WNV) is the leading cause of mosquito-borne disease in the United States and is most commonly spread through an infected mosquito bite even though other modes of transmission such as breastfeeding, transplacental transmission, organ transplantation, blood transfusion, and laboratory acquisition exist. 1 The virus is a member of the Flavivirus genus, making it closely related to the viruses that cause yellow fever, dengue fever, and St Louis encephalitis. 2 The virus was first discovered in Uganda in 1937 and first reported in North America in 1999. 3 Since then, thousands of cases are reported each year with major outbreaks in August and September. 4 To diagnose WNV as the underlying etiology of encephalitis, it is informative to obtain cerebrospinal fluid (CSF) for detection of WNV IgM antibody in addition to the serum antibodies. 5 West Nile virus is the most common cause of viral encephalitis in the United States and is considered a significant contributing cause for numerous cases of neurological dysfunction in the nearest future. 6 According to the US Center for Disease Control and Prevention, approximately 80% of infected people are asymptomatic or have mild symptoms. 7 All ages are affected with highest incidence

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The Diagnosis and Treatment of Idiopathic Facial Paresis (Bell’s Palsy)

Cited by 111 publications

References 70 publications

Facial nerve electrodiagnostics for patients with facial palsy: a clinical practice guideline

Facial nerve electrodiagnostics for patients with facial palsy: a clinical practice guideline

Lockdown-related idiopathic facial paralysis: illustration of an indirect victim of the COVID-19 pandemic?

New onset of Bell’s palsy in a patient with West Nile Encephalitis

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