31 research outputs found
Management of peripheral facial nerve palsy
Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bellâs palsy). Three quarters of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the presence of typical symptoms and signs, blood chemical investigations, cerebro-spinal-fluid-investigations, X-ray of the scull and mastoid, cerebral MRI, or nerve conduction studies. Bellâs palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary FNP and Bellâs palsy may coexist. Treatment of secondary FNP is based on the therapy of the underlying disorder. Treatment of Bellâs palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. Prognosis of Bellâs palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae