Peripheral Facial Palsy: Etiology, Diagnosis and TreatmentRoob G. · Fazekas F. · Hartung H.-P.
Department of Neurology, Karl Franzens University, Graz, Austria
Treatment options for peripheral facial palsy (PFP) are an often discussed problem in neurologic practice. Following a short description of the complex anatomy of the seventh cranial nerve we therefore review possible etiologies in the context of leading clinical signs, with idiopathic PFP or Bell’s palsy (BP) being most frequent. A rather typical clinical course of BP allows to focus differential diagnostic workup predominantly on the rapid identification of treatable infections such as with Herpes zoster or Borrelia burgdorferi. Neuroimaging studies are needed only in case of trauma, with slowly developing PFP or in the presence of associated signs and symptoms. As BP is characterized by an overall high rate of spontaneous recovery, major emphasis has to be put on avoiding complications by protecting the eye. Meta-analysis of four randomized controlled studies suggests a marginal benefit of steroids concerning eventual achievement of complete recovery. Beneficial effects of a combination of acyclovir and prednisone have also been claimed. While such therapies may be considered in patients with a presumptive bad prognosis, more general recommendations on medical treatment of BP will have to await further trials.
Gudrun Roob, MD
Department of Neurology, Karl Franzens University
A–8036 Graz (Austria)
Tel. +43 316 385 2385, Fax +43 316 325520
Received: Received: May 18, 1998
Accepted: July 27, 1998
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 1, Number of References : 43
Founded 1897 as ‘Monatsschrift für Psychiatrie und Neurologie’
Vol. 41, No. 1, Year 1999 (Cover Date: Released January 1999)
Journal Editor: J. Bogousslavsky, Lausanne
ISSN: 0014–3022 (print), 1421–9913 (Online)
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