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Bells Palsy

 

Acute Lower motor neurone facial palsy: Unilateral, including forehead. 

Management:

Support, eye protection, Prednisolone 25mg bd for 5d

Do glucose as increased incidence w Diabetes 

If due to varicella zoster e.g. Ramsay Hunt- Antivirals. Look for rash in mouth and ear. 

If Ear symptoms e.g. rash, d/c, pain, parotid disease refer to ENT 

Eye irritation/complication refer Ophthalmology 

Systemic symptoms e.g. fever/headache /malaise or if immunocompromised–consider admission 

If suspect cancer 2ww referral. 


Refer to neurology

Bilateral Paresis

Palsy not recovering by 3/12

Upper Motor Neurone pattern (Sparing forehead)

Associated Cranial nerve, cerebellar, sensory or motor symptoms or signs in the limbs

If already known to Neurology services contact relevant team, including MS Nurses if MS related