Bell`s palsy: etiology, clinical manifestations, diagnostics and treatment

Ieva Jonušaitė1

1Vilnius University, Faculty of Medicine


Aim: to review presenting articles about aetiology, clinical manifestation, diagnostics and treatment recommendations of Bell`s palsy.

Methods. The literature review was done in English using PubMed and Google Scholar data basis. Keywords “Bell`s palsy”, “idiopathic facial nerve palsy”, “peripheral facial nerve palsy” and “management of facial nerve palsy” were used. There were no limitations to the publication period of articles or clinical cases. Results were divided into aetiology, clinical manifestations, diagnostics and treatment groups.

Summary. Bell`s palsy is the most common acute mononeuropathy, which occurs to 11,5 – 53,3/100 000 people worldwide every year. Even in 60 – 75% of the cases, the exact etiological factor of the peripheral facial nerve palsy is unknown, it is believed that many poorly explored factors such as anatomical structural variations, autoimmunity, infections, ischemia and environmental exposure are hidden under the diagnosis of idiopathic Bell`s palsy. The most common of them is the infection caused by Herpes simplex virus 1 (HSV – 1). The diagnosis of Bell`s palsy is mainly clinical and routinely none of the laboratory or visual tests is performed. Although facial muscles weakness can resolve on its own, to prevent complications glucocorticoids are administrated (with antiviral therapy if there is a suspicion of viral infection). The treatment is successful and decreases the risk of residual events for 95% of the cases.

Keywords: Bell`s palsy, idiopathic facial nerve palsy, peripheral facial nerve palsy.