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6 Cards in this Set
- Front
- Back
Acute peripheral nerve palsy affecting CN VII (Facial Nerve)
Generally a unilateral presentation but in rare cases it can affect both sides Annual incidence estimated 15-30 cases per 100,000 persons Peak incidence in 4th decade Increased frequency in diabetics and pregnant females |
Bell's Palsy
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Bell's Palsy is believed to be caused how?
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Believed to be caused by inflammation of the facial nerve in the Geniculate Ganglion at the stylomastoid foramen
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What are the symptoms of Bell's Palsy
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Symptoms usually begin suddenly
Mild weakness to total paralysis Forehead unfurrows Eyelid will not close, lower lid sags Eye rolls upward on attempted closure Facial creases and nasolabial fold disappear Corner of the mouth droops Impairment of taste Prodrome of ear pain, hyperacusis is variable Maximal weakness usually within 48 hours Facial Sensation is Preserved |
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What is the TX for Bell's Palsy
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Mainstay of treatment is early (within 72 hours) oral Glucocorticoid Treatment (Prednisone)
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If someone has very severe Bell's Palsy, and you feel as if HSV-1 virus may be a factor, what is the TX?
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Comibined therapy with Prednisone (60-80mg) and Valacyclovir (Valtrex)
1gram three times daily for seven days |
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If a patient with Bell's Palsy doesn't improve in 3 weeks what do you do?
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Refer to Neurology patients with bilateral palsies or patients who do not improve within three weeks of symptom onset
Electromyography studies may be performed |