SherbyNet - /page/wikibook/entry.mu

Micron Document

<!DOCTYPE html>

<title>Bell's palsy</title>

</head>

Bell's palsy

</h1>

</header>

/* start https://en.wikipedia.org/ */

.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}

/* end https://en.wikipedia.org/ */

</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Bell's palsy</th></tr><tr><td colspan="2" class="infobox-full-data"></td></tr><tr><td colspan="2" class="infobox-full-data">A person attempting to show his teeth and raise his eyebrows with Bell's palsy on his right side. Note how the forehead is not spared.</td></tr><tr><th scope="row" class="infobox-label"><a href="Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="Neurology" title="Neurology">Neurology</a>, <a href="Ophthalmology" title="Ophthalmology">Ophthalmology</a>, <a href="Otorhinolaryngology" title="Otorhinolaryngology">ENT</a>, <a href="Oral_and_maxillofacial_surgery" title="Oral and maxillofacial surgery">oral and maxillofacial surgery</a></td></tr><tr><th scope="row" class="infobox-label"><a href="Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">Inability to move the <a href="Facial_muscle" class="mw-redirect" title="Facial muscle">facial muscles</a> on one side, change in <a href="Taste" title="Taste">taste</a>, pain around the ear<a href="#cite_note-NIH2016-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">Over 48 hours<a href="#cite_note-NIH2016-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">< 6 months<a href="#cite_note-NIH2016-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="Cause_(medicine)" title="Cause (medicine)">Causes</a></th><td class="infobox-data">Unknown<a href="#cite_note-NIH2016-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data"><a href="Diabetes" title="Diabetes">Diabetes</a>, recent <a href="Upper_respiratory_tract_infection" title="Upper respiratory tract infection">upper respiratory tract infection</a><a href="#cite_note-NIH2016-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Based on symptoms<a href="#cite_note-NIH2016-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="Brain_tumor" title="Brain tumor">Brain tumor</a>, <a href="Stroke" title="Stroke">stroke</a>, <a href="Ramsay_Hunt_syndrome_type_2" title="Ramsay Hunt syndrome type 2">Ramsay Hunt syndrome type 2</a>, <a href="Lyme_disease" title="Lyme disease">Lyme disease</a><a href="#cite_note-Ful2016-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="Corticosteroid" title="Corticosteroid">Corticosteroids</a>, <a href="Eye_drops" class="mw-redirect" title="Eye drops">eye drops</a>, <a href="Eyepatch" title="Eyepatch">eyepatch</a><a href="#cite_note-NIH2016-1">[1]</a><a href="#cite_note-ReferenceA-3">[3]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">Most recover completely<a href="#cite_note-NIH2016-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">1–4 per 10,000 per year<a href="#cite_note-Ful2016-2">[2]</a></td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">

/* start https://en.wikipedia.org/ */

@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}

/* end https://en.wikipedia.org/ */

</style>

Bell's palsy is a type of <a href="Facial_paralysis" class="mw-redirect" title="Facial paralysis">facial paralysis</a> that results in a temporary inability to control the <a href="Facial_muscles" title="Facial muscles">facial muscles</a> on the affected side of the face.<a href="#cite_note-NIH2016-1">[1]</a> In most cases, the weakness is temporary and significantly improves over weeks.<a href="#cite_note-:1-4">[4]</a> Symptoms can vary from mild to severe.<a href="#cite_note-NIH2016-1">[1]</a> They may include muscle twitching, weakness, or total loss of the ability to move one or, in rare cases, both sides of the face.<a href="#cite_note-NIH2016-1">[1]</a> Other symptoms include drooping of the eyebrow,<a href="#cite_note-5">[5]</a> a change in <a href="Taste" title="Taste">taste</a>, and pain around the ear. Typically symptoms come on over 48 hours.<a href="#cite_note-NIH2016-1">[1]</a> Bell's palsy can trigger an increased sensitivity to sound known as <a href="Hyperacusis" title="Hyperacusis">hyperacusis</a>.<a href="#cite_note-Purves1-6">[6]</a>

The cause of Bell's palsy is unknown<a href="#cite_note-NIH2016-1">[1]</a> and it can occur at any age.<a href="#cite_note-:1-4">[4]</a> Risk factors include <a href="Diabetes" title="Diabetes">diabetes</a>, a recent <a href="Upper_respiratory_tract_infection" title="Upper respiratory tract infection">upper respiratory tract infection</a>, and <a href="Pregnancy" title="Pregnancy">pregnancy</a>.<a href="#cite_note-NIH2016-1">[1]</a><a href="#cite_note-Preg2017-7">[7]</a> It results from a dysfunction of <a href="Cranial_nerve_VII" class="mw-redirect" title="Cranial nerve VII">cranial nerve VII</a> (the facial nerve).<a href="#cite_note-NIH2016-1">[1]</a> Many believe that this is due to a viral infection that results in swelling.<a href="#cite_note-NIH2016-1">[1]</a> Diagnosis is based on a person's appearance and ruling out other possible causes.<a href="#cite_note-NIH2016-1">[1]</a> Other conditions that can cause facial weakness include <a href="Brain_tumor" title="Brain tumor">brain tumor</a>, <a href="Stroke" title="Stroke">stroke</a>, <a href="Ramsay_Hunt_syndrome_type_2" title="Ramsay Hunt syndrome type 2">Ramsay Hunt syndrome type 2</a>, <a href="Myasthenia_gravis" title="Myasthenia gravis">myasthenia gravis</a>, and <a href="Lyme_disease" title="Lyme disease">Lyme disease</a>.<a href="#cite_note-Ful2016-2">[2]</a>

The condition normally gets better by itself, with most achieving normal or near-normal function.<a href="#cite_note-NIH2016-1">[1]</a> <a href="Corticosteroids" class="mw-redirect" title="Corticosteroids">Corticosteroids</a> have been found to improve outcomes, while <a href="Antiviral_medications" class="mw-redirect" title="Antiviral medications">antiviral medications</a> may be of a small additional benefit.<a href="#cite_note-Gag2015-8">[8]</a> The eye should be protected from drying up with the use of <a href="Eye_drops" class="mw-redirect" title="Eye drops">eye drops</a> or an <a href="Eyepatch" title="Eyepatch">eyepatch</a>.<a href="#cite_note-NIH2016-1">[1]</a> Surgery is generally not recommended.<a href="#cite_note-NIH2016-1">[1]</a> Often signs of improvement begin within 14 days, with complete recovery within six months.<a href="#cite_note-NIH2016-1">[1]</a> A few may not recover completely or have a recurrence of symptoms.<a href="#cite_note-NIH2016-1">[1]</a>

Bell's palsy is the most common cause of one-sided facial nerve paralysis (70%).<a href="#cite_note-Ful2016-2">[2]</a><a href="#cite_note-9">[9]</a> It occurs in 1 to 4 per 10,000 people per year.<a href="#cite_note-Ful2016-2">[2]</a> About 1.5% of people are affected at some point in their lives.<a href="#cite_note-10">[10]</a> It most commonly occurs in people between ages 15 and 60.<a href="#cite_note-NIH2016-1">[1]</a> Males and females are affected equally.<a href="#cite_note-NIH2016-1">[1]</a> It is named after Scottish surgeon <a href="Charles_Bell" title="Charles Bell">Charles Bell</a> (1774–1842), who first described the connection of the facial nerve to the condition.<a href="#cite_note-NIH2016-1">[1]</a>

Although defined as a <a href="Mononeuropathy" class="mw-redirect" title="Mononeuropathy">mononeuritis</a> (involving only one nerve), people diagnosed with Bell's palsy may have "myriad neurological symptoms", including "facial tingling, moderate or severe headache/neck pain, memory problems, balance problems, ipsilateral limb paresthesias, ipsilateral limb weakness, and a sense of clumsiness" that are "unexplained by facial nerve dysfunction".<a href="#cite_note-Morris-11">[11]</a>

<div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2></div>

Bell's palsy is characterized by a one-sided facial droop that comes on within 72 hours.<a href="#cite_note-CPG2013-12">[12]</a> In rare cases (<1%), it can occur on both sides resulting in total facial paralysis.<a href="#cite_note-13">[13]</a><a href="#cite_note-14">[14]</a>

The facial nerve controls many functions, such as blinking and closing the <a href="Eye" title="Eye">eyes</a>, <a href="Smiling" class="mw-redirect" title="Smiling">smiling</a>, <a href="Frowning" class="mw-redirect" title="Frowning">frowning</a>, <a href="Lacrimation" class="mw-redirect" title="Lacrimation">lacrimation</a>, <a href="Salivation" class="mw-redirect" title="Salivation">salivation</a>, flaring <a href="Nostrils" class="mw-redirect" title="Nostrils">nostrils</a> and raising <a href="Eyebrow" title="Eyebrow">eyebrows</a>. It also carries <a href="Taste" title="Taste">taste</a> sensations from the anterior two thirds of the <a href="Tongue" title="Tongue">tongue</a>, through the <a href="Chorda_tympani" title="Chorda tympani">chorda tympani nerve</a> (a branch of the facial nerve). Because of this, people with Bell's palsy may present with <a href="Ageusia" title="Ageusia">loss of taste sensation</a> in the anterior two thirds of the tongue on the affected side.<a href="#cite_note-:0-15">[15]</a>

The facial nerve innervates the <a href="Stapedius_muscle" title="Stapedius muscle">stapedius muscle</a> of the <a href="Middle_ear" title="Middle ear">middle ear</a> (through the <a href="Nerve_to_the_stapedius" title="Nerve to the stapedius">tympanic branch</a>), which reflexively dampens the conduction of loud sounds. Thus, Bell's Palsy may cause normal sounds to be perceived as very loud (<a href="Hyperacusis" title="Hyperacusis">hyperacusis</a>), and <a href="Dysacusis" title="Dysacusis">dysacusis</a> is possible but hardly ever clinically evident.<a href="#cite_note-:0-15">[15]</a><a href="#cite_note-moore-16">[16]</a>

<div class="mw-heading mw-heading2"><h2 id="Cause">Cause</h2></div>

The cause of Bell's palsy is unknown.<a href="#cite_note-NIH2016-1">[1]</a> Risk factors include <a href="Diabetes" title="Diabetes">diabetes</a>, a recent <a href="Upper_respiratory_tract_infection" title="Upper respiratory tract infection">upper respiratory tract infection</a>, and <a href="Pregnancy" title="Pregnancy">pregnancy</a>.<a href="#cite_note-NIH2016-1">[1]</a><a href="#cite_note-Preg2017-7">[7]</a>

Some viruses are thought to establish a persistent (or <a href="Virus_latency" title="Virus latency">latent</a>) infection without symptoms, e.g., the <a href="Varicella_zoster_virus" title="Varicella zoster virus">varicella zoster virus</a><a href="#cite_note-17">[17]</a> and the <a href="Epstein%E2%80%93Barr_virus" title="Epstein–Barr virus">Epstein–Barr virus</a>, both of the <a href="Herpesviridae#Human_herpesvirus_types" title="Herpesviridae">herpes family</a>. Reactivation of an existing (dormant) viral infection has been suggested as a cause of acute Bell's palsy.<a href="#cite_note-Furuta-18">[18]</a> As the facial nerve swells and becomes inflamed in reaction to the infection, it causes pressure within the <a href="Facial_canal" title="Facial canal">Fallopian canal</a>, resulting in the restriction of blood and oxygen to the nerve cells.<a href="#cite_note-19">[19]</a> Other viral and bacterial infections that have been linked to the development of Bell's palsy include <a href="HIV" title="HIV">HIV</a> and <a href="Lyme_disease" title="Lyme disease">Lyme disease</a>.<a href="#cite_note-20">[20]</a><a href="#cite_note-21">[21]</a> This new activation could be triggered by trauma, environmental factors, and metabolic or emotional disorders.<a href="#cite_note-Kasse-22">[22]</a>

Familial inheritance has been found in 4–14% of cases.<a href="#cite_note-Familial-23">[23]</a> There may also be an association with <a href="Migraines" class="mw-redirect" title="Migraines">migraines</a>.<a href="#cite_note-24">[24]</a>

In December 2020, the U.S. <a href="Food_and_Drug_Administration" title="Food and Drug Administration">FDA</a> recommended that recipients of the <a href="Pfizer%E2%80%93BioNTech_COVID-19_vaccine" title="Pfizer–BioNTech COVID-19 vaccine">Pfizer</a> and <a href="Moderna_COVID-19_vaccine" title="Moderna COVID-19 vaccine">Moderna COVID-19 vaccines</a> should be monitored for symptoms of Bell's palsy after several cases were reported among clinical trial participants, though the data were not sufficient to determine a causal link.<a href="#cite_note-25">[25]</a>

<div class="mw-heading mw-heading3"><h3 id="Genetics">Genetics</h3></div>

A meta-analysis of genome-wide association study (GWAS) identified the first unequivocal association with Bell's palsy.<a href="#cite_note-26">[26]</a>

<div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2></div>

Bell's palsy is the result of a malfunction of the <a href="Facial_nerve" title="Facial nerve">facial nerve</a> (<a href="Cranial_nerve" class="mw-redirect" title="Cranial nerve">cranial nerve</a> VII), which controls the <a href="Muscle" title="Muscle">muscles</a> of the face. Facial palsy is typified by an inability to move the muscles of facial expression. The paralysis is of the infranuclear/lower motor neuron type.

It is thought that as a result of <a href="Inflammation" title="Inflammation">inflammation</a> of the facial nerve, pressure is produced on the nerve where it exits the skull within its bony canal (the <a href="Stylomastoid_foramen" title="Stylomastoid foramen">stylomastoid foramen</a>), blocking the transmission of neural signals or damaging the nerve. Patients with facial palsy for which an underlying cause can be found are not considered to have Bell's palsy per se. Possible causes of facial paralysis include <a href="Tumor" class="mw-redirect" title="Tumor">tumor</a>, <a href="Meningitis" title="Meningitis">meningitis</a>, <a href="Stroke" title="Stroke">stroke</a>, <a href="Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">diabetes mellitus</a>, <a href="Head_injury" title="Head injury">head trauma</a> and inflammatory diseases of the cranial nerves (<a href="Sarcoidosis" title="Sarcoidosis">sarcoidosis</a>, <a href="Brucellosis" title="Brucellosis">brucellosis</a>, etc.). In these conditions, the neurologic findings are rarely restricted to the facial nerve. Babies can be born with facial palsy.<a href="#cite_note-27">[27]</a> In a few cases, bilateral facial palsy has been associated with <a href="Acute_HIV_infection" class="mw-redirect" title="Acute HIV infection">acute HIV infection</a>.

In some research, the <a href="Herpes_simplex_virus" title="Herpes simplex virus">herpes simplex virus</a> type 1 (HSV-1) has been identified in a majority of cases diagnosed as Bell's palsy through endoneurial fluid sampling.<a href="#cite_note-28">[28]</a> Other research, however, identified, out of a total of 176 cases diagnosed as Bell's palsy, HSV-1 in 31 cases (18%) and <a href="Herpes_zoster" class="mw-redirect" title="Herpes zoster">herpes zoster</a> in 45 cases (26%).<a href="#cite_note-Furuta-18">[18]</a>

In addition, HSV-1 infection is associated with <a href="Demyelination" class="mw-redirect" title="Demyelination">demyelination</a> of nerves. This nerve damage mechanism is different from the above-mentioned—that edema, swelling, and compression of the nerve in the narrow bone canal are responsible for nerve damage. Demyelination may not even be directly caused by the virus but by an unknown <a href="Immune_system" title="Immune system">immune</a> response.

<div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2></div>

Bell's palsy is a <a href="Diagnosis_of_exclusion" title="Diagnosis of exclusion">diagnosis of exclusion</a>, meaning it is diagnosed by the elimination of other reasonable possibilities. By definition, no specific cause can be determined. There are no routine lab or imaging tests required to make the diagnosis.<a href="#cite_note-CPG2013-12">[12]</a> The degree of nerve damage can be assessed using the <a href="House-Brackmann_score" class="mw-redirect" title="House-Brackmann score">House-Brackmann score</a>.

One study found that 45% of patients are not referred to a specialist, which suggests that Bell's palsy is considered by physicians to be a straightforward diagnosis that is easy to manage.<a href="#cite_note-Morris-11">[11]</a>

Other conditions that can cause similar symptoms include <a href="Herpes_zoster" class="mw-redirect" title="Herpes zoster">herpes zoster</a>, <a href="Lyme_disease" title="Lyme disease">Lyme disease</a>, <a href="Sarcoidosis" title="Sarcoidosis">sarcoidosis</a>, <a href="Stroke" title="Stroke">stroke</a>, and <a href="Brain_tumor" title="Brain tumor">brain tumors</a>.<a href="#cite_note-CPG2013-12">[12]</a>

<div class="mw-heading mw-heading3"><h3 id="Differential_diagnosis">Differential diagnosis</h3></div>

Once the facial paralysis sets in, many people may mistake it as a symptom of a stroke; however, there are a few subtle differences. A stroke will usually cause a few additional symptoms, such as numbness or weakness in the arms and legs. And unlike Bell's palsy, a stroke will usually let patients control the upper part of their faces. A person with a stroke will usually have some wrinkling on their forehead.<a href="#cite_note-29">[29]</a><a href="#cite_note-garro_2018-30">[30]</a>

In areas where <a href="Lyme_disease" title="Lyme disease">Lyme disease</a> is common, it accounts for about 25% of cases of facial palsy.<a href="#cite_note-garro_2018-30">[30]</a> In the U.S., Lyme is most common in the <a href="New_England" title="New England">New England</a> and <a href="Mid-Atlantic_(United_States)" title="Mid-Atlantic (United States)">Mid-Atlantic</a> states and parts of <a href="Wisconsin" title="Wisconsin">Wisconsin</a> and <a href="Minnesota" title="Minnesota">Minnesota</a>.<a href="#cite_note-CDC-Lyme-Data-31">[31]</a> The first sign of about 80% of Lyme infections, typically one or two weeks after a tick bite, is usually an <a href="Erythema_migrans" title="Erythema migrans">expanding rash</a> that may be accompanied by headaches, body aches, fatigue, or fever.<a href="#cite_note-CDC_Lyme_rashes-32">[32]</a> In up to 10–15% of Lyme infections, facial palsy appears several weeks later, and may be the first sign of infection that is noticed as the Lyme rash typically does not itch and is not painful.<a href="#cite_note-wright_2012-33">[33]</a><a href="#cite_note-NEJM2014-34">[34]</a> The likelihood that the facial palsy is caused by Lyme disease should be estimated, based on the recent history of outdoor activities in likely tick habitats during warmer months, a recent history of rash or symptoms such as headache and fever, and whether the palsy affects both sides of the face (much more common in Lyme than in Bell's palsy). If that likelihood is more than negligible, a serological test for Lyme disease should be performed, and if it exceeds 10%, <a href="Empiric_therapy" title="Empiric therapy">empiric therapy</a> with antibiotics should be initiated, without <a href="Corticosteroids" class="mw-redirect" title="Corticosteroids">corticosteroids</a>, and reevaluated upon completion of laboratory tests for Lyme disease.<a href="#cite_note-garro_2018-30">[30]</a> Corticosteroids have been found to harm outcomes for facial palsy caused by Lyme disease.<a href="#cite_note-garro_2018-30">[30]</a>

One disease that may be difficult to exclude in the <a href="Differential_diagnosis" title="Differential diagnosis">differential diagnosis</a> is the involvement of the facial nerve in infections with the <a href="Herpes_zoster" class="mw-redirect" title="Herpes zoster">herpes zoster</a> virus. The major differences in this condition are the presence of small blisters, or vesicles, on the external ear, significant pain in the jaw, ear, face, and/or neck, and hearing disturbances, but these findings may occasionally be lacking (<a href="Herpes_zoster" class="mw-redirect" title="Herpes zoster">zoster sine herpete</a>). Reactivation of existing <a href="Herpes_zoster" class="mw-redirect" title="Herpes zoster">herpes zoster</a> infection leading to facial paralysis in a Bell's palsy type pattern is known as <a href="Ramsay_Hunt_syndrome_type_2" title="Ramsay Hunt syndrome type 2">Ramsay Hunt syndrome type 2</a>. The prognosis for Bell's palsy patients is generally much better than for Ramsay Hunt syndrome type 2 patients.<a href="#cite_note-35">[35]</a>

<div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2></div>

Steroids are effective at improving recovery in Bell's palsy while antivirals have not.<a href="#cite_note-CPG2013-12">[12]</a> In those who are unable to close their eyes, eye-protective measures are required.<a href="#cite_note-CPG2013-12">[12]</a> Management during pregnancy is similar to management in the non-pregnant.<a href="#cite_note-Preg2017-7">[7]</a>

<div class="mw-heading mw-heading3"><h3 id="Steroids">Steroids</h3></div>

<a href="Corticosteroid" title="Corticosteroid">Corticosteroids</a> such as <a href="Prednisone" title="Prednisone">prednisone</a> improve recovery at 6 months and are thus recommended.<a href="#cite_note-ReferenceA-3">[3]</a> Early treatment (within 3 days after the onset) is necessary for benefit<a href="#cite_note-Surgery09-36">[36]</a> with a 14% greater probability of recovery.<a href="#cite_note-Evidence-based_guideline_update:_st-37">[37]</a> There is some debate regarding the optimal dosing strategy which is generally physician dependent.<a href="#cite_note-38">[38]</a>

<div class="mw-heading mw-heading3"><h3 id="Antivirals">Antivirals</h3></div>

One review found that <a href="Antivirals" class="mw-redirect" title="Antivirals">antivirals</a> (such as <a href="Aciclovir" title="Aciclovir">aciclovir</a>) are ineffective in improving recovery from Bell's palsy beyond steroids alone in mild to moderate disease.<a href="#cite_note-Antiviral_treatment_of_Bell's_palsy-39">[39]</a> Another review found a benefit when combined with corticosteroids but stated the evidence was not very good to support this conclusion.<a href="#cite_note-Gag2015-8">[8]</a>

In severe disease, it is also unclear. One 2015 review found no effect regardless of severity.<a href="#cite_note-Antiviral_treatment_of_Bell's_palsy-39">[39]</a> Another review found a small benefit when added to steroids.<a href="#cite_note-Gag2015-8">[8]</a>

They are commonly prescribed due to a theoretical link between Bell's palsy and the <a href="Herpes_simplex" class="mw-redirect" title="Herpes simplex">herpes simplex</a> and <a href="Varicella_zoster_virus" title="Varicella zoster virus">varicella zoster virus</a>.<a href="#cite_note-Sullivan-NEJM-40">[40]</a> There is still the possibility that they might result in a benefit less than 7% as this has not been ruled out.<a href="#cite_note-Evidence-based_guideline_update:_st-37">[37]</a>

<div class="mw-heading mw-heading3"><h3 id="Eye_protection">Eye protection</h3></div>

When Bell's palsy affects the blink reflex and stops the eye from closing completely, frequent use of tear-like eye drops or eye ointments is recommended during the day, and protecting the eyes with patches or taping them shut is recommended for sleep and rest periods.<a href="#cite_note-garro_2018-30">[30]</a><a href="#cite_note-OTC-Drops-41">[41]</a>

<div class="mw-heading mw-heading3"><h3 id="Physiotherapy">Physiotherapy</h3></div>

<a href="Physiotherapy" class="mw-redirect" title="Physiotherapy">Physiotherapy</a> can be beneficial to some individuals with Bell's palsy as it helps to maintain <a href="Muscle_tone" title="Muscle tone">muscle tone</a> of the affected <a href="Facial_muscles" title="Facial muscles">facial muscles</a> and stimulate the <a href="Facial_nerve" title="Facial nerve">facial nerve</a>.<a href="#cite_note-ninds-42">[42]</a> It is important that muscle re-education exercises and <a href="Soft_tissue_technique" class="mw-redirect" title="Soft tissue technique">soft tissue techniques</a> be implemented before recovery to help prevent permanent <a href="Contractures" class="mw-redirect" title="Contractures">contractures</a> of the <a href="Paralysis" title="Paralysis">paralyzed</a> facial muscles.<a href="#cite_note-ninds-42">[42]</a> To reduce <a href="Pain" title="Pain">pain</a>, heat can be applied to the affected side of the face.<a href="#cite_note-43">[43]</a> There is no high-quality evidence to support the role of electrical stimulation for Bell's palsy.<a href="#cite_note-44">[44]</a>

<div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3></div>

Surgery may be able to improve outcomes in facial nerve palsy that has not recovered.<a href="#cite_note-Surgery09-36">[36]</a> A number of different techniques exist.<a href="#cite_note-Surgery09-36">[36]</a> <a href="Smile_surgery" title="Smile surgery">Smile surgery</a> or smile reconstruction is a surgical procedure that may restore the smile for people with facial nerve paralysis. Adverse effects include hearing loss which occurs in 3–15% of people.<a href="#cite_note-AFP2007-45">[45]</a> A Cochrane review (updated in 2021), after reviewing applicable <a href="Randomized_controlled_trial" title="Randomized controlled trial">randomized and quasi-randomized controlled trials</a> was unable to determine if early surgery is beneficial or harmful.<a href="#cite_note-46">[46]</a> As of 2007 the <a href="American_Academy_of_Neurology" title="American Academy of Neurology">American Academy of Neurology</a> did not recommend surgical decompression.<a href="#cite_note-AFP2007-45">[45]</a>

<div class="mw-heading mw-heading3"><h3 id="Alternative_medicine">Alternative medicine</h3></div>

The efficacy of <a href="Acupuncture" title="Acupuncture">acupuncture</a> remains unknown because the available studies are of low quality (poor primary study design or inadequate reporting practices).<a href="#cite_note-acupuncture-47">[47]</a> There is very tentative evidence for <a href="Hyperbaric_oxygen_therapy" class="mw-redirect" title="Hyperbaric oxygen therapy">hyperbaric oxygen therapy</a> in severe disease.<a href="#cite_note-48">[48]</a>

<div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2></div>

Most people with Bell's palsy start to regain normal facial function within three weeks—even those who do not receive treatment.<a href="#cite_note-49">[49]</a> In a 1982 study, when no treatment was available, of 1,011 patients, 85% showed first signs of recovery within three weeks after onset. For the other 15%, recovery occurred 3–6 months later.

After a follow-up of at least one year or until restoration, complete recovery had occurred in more than two-thirds (71%) of all patients. Recovery was judged moderate in 12% and poor in only 4% of patients.<a href="#cite_note-50">[50]</a> Another study found that incomplete palsies disappear entirely, nearly always in one month. The patients who regain movement within the first two weeks nearly always remit entirely. When remission does not occur until the third week or later, a significantly greater part of the patients develop <a href="Sequela" title="Sequela">sequelae</a>.<a href="#cite_note-Act_Otol_1966-51">[51]</a> A third study found a better prognosis for young patients, aged below 10 years old, while the patients over 61 years old presented a worse prognosis.<a href="#cite_note-Kasse-22">[22]</a>

Major possible complications of the condition are chronic loss of taste (<a href="Ageusia" title="Ageusia">ageusia</a>), chronic facial <a href="Spasm" title="Spasm">spasm</a>, facial pain, and corneal infections. Another complication can occur in case of incomplete or erroneous regeneration of the damaged facial nerve. The nerve can be thought of as a bundle of smaller individual nerve connections that branch out to their proper destinations. During regrowth, nerves are generally able to track the original path to the right destination—but some nerves may sidetrack leading to a condition known as <a href="Synkinesis" title="Synkinesis">synkinesis</a>. For instance, the regrowth of nerves controlling muscles attached to the eye may sidetrack and also regrow connections reaching the muscles of the mouth. In this way, the movement of one also affects the other. For example, when the person closes the eye, the corner of the mouth lifts involuntarily.

Around 9% of people have some sort of ongoing problems after Bell's palsy, typically the synkinesis already discussed, or spasm, contracture, <a href="Tinnitus" title="Tinnitus">tinnitus</a>, or hearing loss during facial movement or crocodile-tear syndrome.<a href="#cite_note-52">[52]</a> This is also called gustatolacrimal reflex or <a href="Bogorad's_syndrome" class="mw-redirect" title="Bogorad's syndrome">Bogorad's syndrome</a> and results in shedding tears while eating. This is thought to be due to <a href="Synkinesis" title="Synkinesis">faulty regeneration</a> of the facial nerve, a branch of which controls the lacrimal and salivary glands. Gustatorial sweating can also occur.

<div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2></div>

The number of new cases of Bell's palsy ranges from about one to four cases per 10,000 population per year.<a href="#cite_note-Ahmed-53">[53]</a> The rate increases with age.<a href="#cite_note-Ful2016-2">[2]</a><a href="#cite_note-Ahmed-53">[53]</a> Bell's palsy affects about 40,000 people in the United States every year. It affects approximately 1 person in 65 during a lifetime.

A range of annual incidence rates have been reported in the literature: 15,<a href="#cite_note-Familial-23">[23]</a> 24,<a href="#cite_note-54">[54]</a> and 25–53<a href="#cite_note-Morris-11">[11]</a> (all rates per 100,000 population per year). Bell's palsy is not a <a href="Notifiable_disease" title="Notifiable disease">reportable disease</a>, and there are no established registries for people with this diagnosis,<a href="#cite_note-55">[55]</a> which complicates precise estimation.

<div class="mw-heading mw-heading3"><h3 id="Frequency">Frequency</h3></div>

About 40,000 people are affected by Bell's palsy in the United States every year. It can affect anyone of any gender and age, but its incidence seems to be highest in those in the 15- to 45-year-old age group.<a href="#cite_note-NIH2016-1">[1]</a>

<div class="mw-heading mw-heading2"><h2 id="History">History</h2></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}

/* end https://en.wikipedia.org/ */

</style><div role="note" class="hatnote navigation-not-searchable">See also: <a href="List_of_people_with_Bell's_palsy" title="List of people with Bell's palsy">List of people with Bell's palsy</a></div>

The Persian physician <a href="Muhammad_ibn_Zakariya_al-Razi" class="mw-redirect" title="Muhammad ibn Zakariya al-Razi">Muhammad ibn Zakariya al-Razi</a> (865–925) detailed the first known description of peripheral and central facial palsy.<a href="#cite_note-56">[56]</a><a href="#cite_note-57">[57]</a>

Cornelis Stalpart van der Wiel (1620–1702) in 1683 gave an account of Bell's palsy and credited the Persian physician <a href="Ibn_Sina" class="mw-redirect" title="Ibn Sina">Ibn Sina</a> (980–1037) for describing this condition before him. <a href="James_Douglas_(physician)" title="James Douglas (physician)">James Douglas</a> (1675–1742) and Nicolaus Anton Friedreich (1761–1836) also described it.

Scottish neurophysiologist Sir <a href="Charles_Bell" title="Charles Bell">Charles Bell</a> read his paper to the <a href="Royal_Society_of_London" class="mw-redirect" title="Royal Society of London">Royal Society of London</a> on July 12, 1821, describing the role of the facial nerve. He became the first to detail the neuroanatomical basis of facial paralysis. Since then, idiopathic peripheral facial paralysis has been referred to as Bell's palsy, named after him.<a href="#cite_note-58">[58]</a>

A notable person with Bell's palsy is former <a href="Prime_Minister_of_Canada" title="Prime Minister of Canada">Prime Minister of Canada</a> <a href="Jean_Chr%C3%A9tien" title="Jean Chrétien">Jean Chrétien</a>.<a href="#cite_note-59">[59]</a> During the <a href="1993_Canadian_federal_election" title="1993 Canadian federal election">1993 federal election</a>, Chrétien's first as leader of the <a href="Liberal_Party_of_Canada" title="Liberal Party of Canada">Liberal Party</a>, the opposition <a href="Progressive_Conservative_Party_of_Canada" title="Progressive Conservative Party of Canada">Progressive Conservative Party</a> ran <a href="1993_Chr%C3%A9tien_attack_ad" class="mw-redirect" title="1993 Chrétien attack ad">an attack ad</a> in which voice actors criticized him over images that seemed to highlight his abnormal facial expressions. The ad was interpreted as an attack on Chrétien's physical appearance and garnered widespread anger among the public, while Chrétien used the ad to make himself more sympathetic to voters. The ad had the adverse effect of increasing Chrétien's lead in the polls and the subsequent backlash clinched the election for the Liberals, who won in a landslide.

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}

/* end https://en.wikipedia.org/ */

</style><div class="reflist">

/* start https://en.wikipedia.org/ */

.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("./mw/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("./mw/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("./mw/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("./mw/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}

/* end https://en.wikipedia.org/ */

</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.ninds.nih.gov/health-information/disorders/bells-palsy?search-term=disorders%20bells%20palsy">"Bell's Palsy Fact Sheet"</a>. <a href="National_Institute_of_Neurological_Disorders_and_Stroke" title="National Institute of Neurological Disorders and Stroke">National Institute of Neurological Disorders and Stroke</a>. July 25, 2022. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20110408004237/http://www.ninds.nih.gov/disorders/bells/detail_bells.htm">Archived</a> from the original on 8 April 2011. Retrieved October 11, 2022.</cite>

</li>

<li id="cite_note-Ful2016-2">^ <a href="#cite_ref-Ful2016_2-0">a</a> <a href="#cite_ref-Ful2016_2-1">b</a> <a href="#cite_ref-Ful2016_2-2">c</a> <a href="#cite_ref-Ful2016_2-3">d</a> <a href="#cite_ref-Ful2016_2-4">e</a> <a href="#cite_ref-Ful2016_2-5">f</a> <cite id="CITEREFFullerMorgan2016" class="citation journal cs1">Fuller G, Morgan C (December 2016). "Bell's palsy syndrome: mimics and chameleons". Practical Neurology. 16 (6): 439–44. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fpractneurol-2016-001383">10.1136/practneurol-2016-001383</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27034243">27034243</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:4480197">4480197</a>.</cite>

</li>

<li id="cite_note-ReferenceA-3">^ <a href="#cite_ref-ReferenceA_3-0">a</a> <a href="#cite_ref-ReferenceA_3-1">b</a> <cite id="CITEREFMadhokGagyorDalySomasundara2016" class="citation journal cs1">Madhok VB, Gagyor I, Daly F, Somasundara D, Sullivan M, Gammie F, Sullivan F (July 2016). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457861">"Corticosteroids for Bell's palsy (idiopathic facial paralysis)"</a>. The Cochrane Database of Systematic Reviews. 2016 (7): CD001942. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD001942.pub5">10.1002/14651858.CD001942.pub5</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457861">6457861</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27428352">27428352</a>.</cite>

</li>

<li id="cite_note-:1-4">^ <a href="#cite_ref-:1_4-0">a</a> <a href="#cite_ref-:1_4-1">b</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.mayoclinic.org/diseases-conditions/bells-palsy/symptoms-causes/syc-20370028">"Bell's palsy - Symptoms and causes"</a>. Mayo Clinic. Retrieved 2022-03-22.</cite>

</li>

<li id="cite_note-5"><a href="#cite_ref-5">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.ninds.nih.gov/health-information/disorders/bells-palsy?search-term=disorders%20bells%20palsy">"Bell's Palsy"</a>.</cite>

</li>

<li id="cite_note-Purves1-6"><a href="#cite_ref-Purves1_6-0">^</a> <cite id="CITEREFPurves2012" class="citation book cs1">Purves D (2012). Neuroscience (5th ed.). Sunderland, Massachusetts: Sinauer. p. 283. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>9780878936953</bdi>.</cite>

</li>

<li id="cite_note-Preg2017-7">^ <a href="#cite_ref-Preg2017_7-0">a</a> <a href="#cite_ref-Preg2017_7-1">b</a> <a href="#cite_ref-Preg2017_7-2">c</a> <cite id="CITEREFHussainNdukaMothMalhotra2017" class="citation journal cs1">Hussain A, Nduka C, Moth P, Malhotra R (May 2017). "Bell's facial nerve palsy in pregnancy: a clinical review". Journal of Obstetrics and Gynaecology. 37 (4): 409–15. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1080%2F01443615.2016.1256973">10.1080/01443615.2016.1256973</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28141956">28141956</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:205479752">205479752</a>.</cite>

</li>

<li id="cite_note-Gag2015-8">^ <a href="#cite_ref-Gag2015_8-0">a</a> <a href="#cite_ref-Gag2015_8-1">b</a> <a href="#cite_ref-Gag2015_8-2">c</a> <cite id="CITEREFGagyorMadhokDalySomasundara2015" class="citation journal cs1">Gagyor I, Madhok VB, Daly F, Somasundara D, Sullivan M, Gammie F, Sullivan F (November 2015). <a rel="nofollow" class="external text" href="https://discovery.dundee.ac.uk/ws/files/743606/Lockhart_2010.pdf">"Antiviral treatment for Bell's palsy (idiopathic facial paralysis)"</a> (PDF). The Cochrane Database of Systematic Reviews (11): CD001869. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD001869.pub8">10.1002/14651858.CD001869.pub8</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26559436">26559436</a>.</cite>

</li>

<li id="cite_note-9"><a href="#cite_ref-9">^</a> <cite id="CITEREFDickson2014" class="citation book cs1">Dickson G (2014). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=JczaAgAAQBAJ&pg=PA138">Primary Care ENT, An Issue of Primary Care: Clinics in Office Practice</a>. Elsevier Health Sciences. p. 138. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-0323287173</bdi>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160820202912/https://books.google.ca/books?id=JczaAgAAQBAJ&pg=PA138">Archived</a> from the original on 2016-08-20.</cite>

</li>

<li id="cite_note-10"><a href="#cite_ref-10">^</a> <cite id="CITEREFGrewal2014" class="citation book cs1">Grewal DS (2014). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=vyLYBAAAQBAJ&pg=PA46">Atlas of Surgery of the Facial Nerve: An Otolaryngologist's Perspective</a>. Jaypee Brothers Publishers. p. 46. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-9350905807</bdi>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160820201510/https://books.google.ca/books?id=vyLYBAAAQBAJ&pg=PA46">Archived</a> from the original on 2016-08-20.</cite>

</li>

<li id="cite_note-Morris-11">^ <a href="#cite_ref-Morris_11-0">a</a> <a href="#cite_ref-Morris_11-1">b</a> <a href="#cite_ref-Morris_11-2">c</a> <cite id="CITEREFMorrisDeeksHillMidroni2002" class="citation journal cs1">Morris AM, Deeks SL, Hill MD, Midroni G, Goldstein WC, Mazzulli T, et al. (2002). <a rel="nofollow" class="external text" href="http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=ned21255">"Annualized incidence and spectrum of illness from an outbreak investigation of Bell's palsy"</a>. Neuroepidemiology. 21 (5): 255–61. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000065645">10.1159/000065645</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12207155">12207155</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:22771896">22771896</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20090713151821/http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=ned21255">Archived</a> from the original on 2009-07-13.</cite>

</li>

<li id="cite_note-CPG2013-12">^ <a href="#cite_ref-CPG2013_12-0">a</a> <a href="#cite_ref-CPG2013_12-1">b</a> <a href="#cite_ref-CPG2013_12-2">c</a> <a href="#cite_ref-CPG2013_12-3">d</a> <a href="#cite_ref-CPG2013_12-4">e</a> <cite id="CITEREFBaughBasuraIshiiSchwartz2013" class="citation journal cs1">Baugh RF, Basura GJ, Ishii LE, Schwartz SR, Drumheller CM, Burkholder R, et al. (November 2013). "Clinical practice guideline: Bell's Palsy executive summary". Otolaryngology–Head and Neck Surgery. 149 (5): 656–63. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F0194599813506835">10.1177/0194599813506835</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24190889">24190889</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:25468987">25468987</a>.</cite>

</li>

<li id="cite_note-13"><a href="#cite_ref-13">^</a> <cite id="CITEREFPriceFife2002" class="citation journal cs1">Price T, Fife DG (January 2002). "Bilateral simultaneous facial nerve palsy". The Journal of Laryngology and Otology. 116 (1): 46–48. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1258%2F0022215021910113">10.1258/0022215021910113</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11860653">11860653</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:19276545">19276545</a>.</cite>

</li>

<li id="cite_note-14"><a href="#cite_ref-14">^</a> <cite id="CITEREFJainDeshmukhGollomp2006" class="citation journal cs1">Jain V, Deshmukh A, Gollomp S (July 2006). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924702">"Bilateral facial paralysis: case presentation and discussion of differential diagnosis"</a>. Journal of General Internal Medicine. 21 (7): C7–10. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1525-1497.2006.00466.x">10.1111/j.1525-1497.2006.00466.x</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924702">1924702</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16808763">16808763</a>.</cite>

</li>

<li id="cite_note-:0-15">^ <a href="#cite_ref-:0_15-0">a</a> <a href="#cite_ref-:0_15-1">b</a> <cite id="CITEREFMumenthalerMattle2006" class="citation book cs1">Mumenthaler M, Mattle H (2006). <a rel="nofollow" class="external text" href="https://archive.org/details/fundamentalsneur00mume">Fundamentals of Neurology</a>. Germany: Thieme. pp. <a rel="nofollow" class="external text" href="https://archive.org/details/fundamentalsneur00mume/page/n208">197</a>. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-3131364517</bdi>.</cite>

</li>

<li id="cite_note-moore-16"><a href="#cite_ref-moore_16-0">^</a> <cite id="CITEREFMooreDalleyAgur2013" class="citation book cs1">Moore KL, Dalley AF, Agur AM (2013). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=-Le5bc5F0sYC">Clinically Oriented Anatomy</a>. Lippincott Williams & Wilkins. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-1451119459</bdi>.</cite>

</li>

<li id="cite_note-17"><a href="#cite_ref-17">^</a> <a rel="nofollow" class="external text" href="http://www.medicinenet.com/facial_nerve_problems/page3.htm">Facial Nerve Problems and Bell's Palsy Information on MedicineNet.com</a> www.medicinenet.com <a rel="nofollow" class="external text" href="https://web.archive.org/web/20080423075504/http://www.medicinenet.com/facial_nerve_problems/page3.htm">Archived</a> 2008-04-23 at the <a href="Wayback_Machine" title="Wayback Machine">Wayback Machine</a>

</li>

<li id="cite_note-Furuta-18">^ <a href="#cite_ref-Furuta_18-0">a</a> <a href="#cite_ref-Furuta_18-1">b</a> <cite id="CITEREFFurutaOhtaniChidaMesuda2001" class="citation journal cs1 cs1-prop-long-vol">Furuta Y, Ohtani F, Chida E, Mesuda Y, Fukuda S, Inuyama Y (May 2001). "Herpes simplex virus type 1 reactivation and antiviral therapy in patients with acute peripheral facial palsy". Auris, Nasus, Larynx. 28 Suppl (Suppl): S13–17. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0385-8146%2800%2900105-X">10.1016/S0385-8146(00)00105-X</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11683332">11683332</a>.</cite>

</li>

<li id="cite_note-19"><a href="#cite_ref-19">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20161230120933/https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Bells-Palsy-Fact-Sheet">"Bell's Palsy Fact Sheet | National Institute of Neurological Disorders and Stroke"</a>. www.ninds.nih.gov. Archived from <a rel="nofollow" class="external text" href="https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Bells-Palsy-Fact-Sheet">the original</a> on December 30, 2016. Retrieved 2022-03-22.</cite>

</li>

<li id="cite_note-20"><a href="#cite_ref-20">^</a> <cite id="CITEREFLuHu2023" class="citation journal cs1">Lu H, Hu H (17 March 2023). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019170">"Bilateral facial palsy caused by HIV infection: A case report and literature review"</a>. Medicine (Baltimore). 102 (11): e33263. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FMD.0000000000033263">10.1097/MD.0000000000033263</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10019170">10019170</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/36930128">36930128</a>.</cite>

</li>

<li id="cite_note-21"><a href="#cite_ref-21">^</a> <cite id="CITEREFMcEntireChwalisz2024" class="citation journal cs1">McEntire CR, Chwalisz BK (1 May 2024). "Cranial nerve involvement, visual complications and headache syndromes in Lyme disease". Curr Opin Ophthalmol. 35 (3): 265–271. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FICU.0000000000001031">10.1097/ICU.0000000000001031</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/38518069">38518069</a>.</cite>

</li>

<li id="cite_note-Kasse-22">^ <a href="#cite_ref-Kasse_22-0">a</a> <a href="#cite_ref-Kasse_22-1">b</a> <cite id="CITEREFKasseFerriVietlerLeonhardt2003" class="citation journal cs1">Kasse CA, Ferri RG, Vietler EY, Leonhardt FD, Testa JR, Cruz OL (October 2003). "Clinical data and prognosis in 1521 cases of Bell's palsy". International Congress Series. 1240: 641–47. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS0531-5131%2803%2900757-X">10.1016/S0531-5131(03)00757-X</a>.</cite>

</li>

<li id="cite_note-Familial-23">^ <a href="#cite_ref-Familial_23-0">a</a> <a href="#cite_ref-Familial_23-1">b</a> <cite id="CITEREFDönerKutluhan2000" class="citation journal cs1">Döner F, Kutluhan S (2000). <a rel="nofollow" class="external text" href="https://archive.today/20130106003939/http://link.springer.de/link/service/journals/00405/bibs/0257003/02570117.htm">"Familial idiopathic facial palsy"</a>. European Archives of Oto-Rhino-Laryngology. 257 (3): 117–19. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs004050050205">10.1007/s004050050205</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10839481">10839481</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:24403036">24403036</a>. Archived from <a rel="nofollow" class="external text" href="http://link.springer.de/link/service/journals/00405/bibs/0257003/02570117.htm">the original</a> on 2013-01-06.</cite>

</li>

<li id="cite_note-24"><a href="#cite_ref-24">^</a> <cite id="CITEREFSilbersteinSilvestrini2015" class="citation journal cs1">Silberstein SD, Silvestrini M (January 2015). "Does migraine produce facial palsy? For whom the Bell tolls". Neurology. 84 (2): 108–09. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1212%2FWNL.0000000000001136">10.1212/WNL.0000000000001136</a>. <a href="Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<a rel="nofollow" class="external text" href="https://hdl.handle.net/11566%2F206361">11566/206361</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25520314">25520314</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:35589569">35589569</a>.</cite>

</li>

<li id="cite_note-25"><a href="#cite_ref-25">^</a> <cite id="CITEREFHiggins-Dunn2020" class="citation web cs1">Higgins-Dunn, Noah (2020-12-15). <a rel="nofollow" class="external text" href="https://www.cnbc.com/2020/12/15/fda-staff-recommends-watching-for-bells-palsy-in-moderna-and-pfizer-vaccine-recipients.html">"FDA staff recommends watching for Bell's palsy in Moderna and Pfizer vaccine recipients"</a>. CNBC. Retrieved 2020-12-15.</cite>

</li>

<li id="cite_note-26"><a href="#cite_ref-26">^</a> <cite id="CITEREFSkuladottir2021" class="citation journal cs1">Skuladottir, Astros Th (2021-02-18). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893061">"A meta-analysis uncovers the first sequence variant conferring risk of Bell's palsy"</a>. Scientific Reports. 11 (1) 4188. <a href="Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2021NatSR..11.4188S">2021NatSR..11.4188S</a>. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fs41598-021-82736-w">10.1038/s41598-021-82736-w</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893061">7893061</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33602968">33602968</a>.</cite>

</li>

<li id="cite_note-27"><a href="#cite_ref-27">^</a> <a rel="nofollow" class="external text" href="https://medlineplus.gov/ency/article/001425.htm">MedlinePlus Medical Encyclopedia: Facial nerve palsy due to birth trauma</a> retrieved 10 September 2008

</li>

<li id="cite_note-28"><a href="#cite_ref-28">^</a> <cite id="CITEREFMurakamiMizobuchiNakashiroDoi1996" class="citation journal cs1">Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N (January 1996). "Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle". Annals of Internal Medicine. 124 (1 Pt 1): 27–30. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.7326%2F0003-4819-124-1_Part_1-199601010-00005">10.7326/0003-4819-124-1_Part_1-199601010-00005</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/7503474">7503474</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:22790049">22790049</a>.</cite>

</li>

<li id="cite_note-29"><a href="#cite_ref-29">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20160305003313/http://news.yahoo.com/c-tv-reporter-loses-her-smile-bells-palsy-164432652--abc-news-wellness.html">"S.C. TV Reporter Loses Her Smile after a Bell's Palsy Attack"</a>. Archived from <a rel="nofollow" class="external text" href="https://news.yahoo.com/c-tv-reporter-loses-her-smile-bells-palsy-164432652--abc-news-wellness.html">the original</a> on March 5, 2016.</cite>

</li>

<li id="cite_note-garro_2018-30">^ <a href="#cite_ref-garro_2018_30-0">a</a> <a href="#cite_ref-garro_2018_30-1">b</a> <a href="#cite_ref-garro_2018_30-2">c</a> <a href="#cite_ref-garro_2018_30-3">d</a> <a href="#cite_ref-garro_2018_30-4">e</a> <cite id="CITEREFGarroNigrovic2018" class="citation journal cs1">Garro A, Nigrovic LE (May 2018). <a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.annemergmed.2017.08.039">"Managing Peripheral Facial Palsy"</a>. Annals of Emergency Medicine. 71 (5): 618–24. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.annemergmed.2017.08.039">10.1016/j.annemergmed.2017.08.039</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29110887">29110887</a>.</cite>

</li>

<li id="cite_note-CDC-Lyme-Data-31"><a href="#cite_ref-CDC-Lyme-Data_31-0">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/lyme/datasurveillance/">"Lyme Disease Data and surveillance (datasurveillance)"</a>. Lyme Disease. Centers for Disease Control and Prevention. Retrieved April 12, 2019.</cite>

</li>

<li id="cite_note-CDC_Lyme_rashes-32"><a href="#cite_ref-CDC_Lyme_rashes_32-0">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cdc.gov/lyme/signs_symptoms/rashes.html">"Lyme disease rashes and look-alikes (rashes)"</a>. Lyme Disease. Centers for Disease Control and Prevention. Retrieved April 18, 2019.</cite>

</li>

<li id="cite_note-wright_2012-33"><a href="#cite_ref-wright_2012_33-0">^</a> <cite id="CITEREFWrightRiedelTalwaniGilliam2012" class="citation journal cs1">Wright WF, Riedel DJ, Talwani R, Gilliam BL (June 2012). <a rel="nofollow" class="external text" href="http://www.aafp.org/afp/2012/0601/p1086.html">"Diagnosis and management of Lyme disease"</a>. American Family Physician. 85 (11): 1086–93. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22962880">22962880</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20130927081243/http://www.aafp.org/afp/2012/0601/p1086.html">Archived</a> from the original on 27 September 2013.</cite>

</li>

<li id="cite_note-NEJM2014-34"><a href="#cite_ref-NEJM2014_34-0">^</a> <cite id="CITEREFShapiro2014" class="citation journal cs1">Shapiro ED (May 2014). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20161019142422/http://portal.mah.harvard.edu/templatesnew/departments/MTA/Lyme/uploaded_documents/NEJMcp1314325.pdf">"Clinical practice. Lyme disease"</a> (PDF). The New England Journal of Medicine. 370 (18): 1724–31. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMcp1314325">10.1056/NEJMcp1314325</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487875">4487875</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24785207">24785207</a>. Archived from <a rel="nofollow" class="external text" href="http://portal.mah.harvard.edu/templatesnew/departments/MTA/Lyme/uploaded_documents/NEJMcp1314325.pdf">the original</a> (PDF) on 19 October 2016.</cite>

</li>

<li id="cite_note-35"><a href="#cite_ref-35">^</a> <cite id="CITEREFAndrew_E._CrouchMarc_H._HohmanClaudio_Andaloro2022" class="citation book cs1">Andrew E. Crouch; Marc H. Hohman; Claudio Andaloro (2022). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/books/NBK557409/">Ramsay Hunt Syndrome</a>. StatPearls. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32491341">32491341</a>.</cite>

</li>

<li id="cite_note-Surgery09-36">^ <a href="#cite_ref-Surgery09_36-0">a</a> <a href="#cite_ref-Surgery09_36-1">b</a> <a href="#cite_ref-Surgery09_36-2">c</a> <cite id="CITEREFHazinAzizzadehBhatti2009" class="citation journal cs1">Hazin R, Azizzadeh B, Bhatti MT (November 2009). "Medical and surgical management of facial nerve palsy". Current Opinion in Ophthalmology. 20 (6): 440–50. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FICU.0b013e3283313cbf">10.1097/ICU.0b013e3283313cbf</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19696671">19696671</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:45094564">45094564</a>.</cite>

</li>

<li id="cite_note-Evidence-based_guideline_update:_st-37">^ <a href="#cite_ref-Evidence-based_guideline_update:_st_37-0">a</a> <a href="#cite_ref-Evidence-based_guideline_update:_st_37-1">b</a> <cite id="CITEREFGronsethPaduga2012" class="citation journal cs1">Gronseth GS, Paduga R (November 2012). <a rel="nofollow" class="external text" href="https://doi.org/10.1212%2FWNL.0b013e318275978c">"Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology"</a>. Neurology. 79 (22): 2209–13. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1212%2FWNL.0b013e318275978c">10.1212/WNL.0b013e318275978c</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23136264">23136264</a>.</cite>

</li>

<li id="cite_note-38"><a href="#cite_ref-38">^</a> <cite id="CITEREFGuptaBalaiTangAhmed2023" class="citation journal cs1">Gupta, Keshav Kumar; Balai, Edward; Tang, Ho Tsun; Ahmed, Abiya Amna; Doshi, Jayesh R. (2023-04-01). "Comparing the Use of High-Dose to Standard-Dose Corticosteroids for the Treatment of Bell's Palsy in Adults-A Systematic Review and Meta-analysis". Otology & Neurotology. 44 (4): 310–316. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FMAO.0000000000003823">10.1097/MAO.0000000000003823</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1537-4505">1537-4505</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/36706448">36706448</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:256326046">256326046</a>.</cite>

</li>

<li id="cite_note-Antiviral_treatment_of_Bell's_palsy-39">^ <a href="#cite_ref-Antiviral_treatment_of_Bell's_palsy_39-0">a</a> <a href="#cite_ref-Antiviral_treatment_of_Bell's_palsy_39-1">b</a> <cite id="CITEREFTurgeonWilbyEnsom2015" class="citation journal cs1">Turgeon RD, Wilby KJ, Ensom MH (June 2015). "Antiviral treatment of Bell's palsy based on baseline severity: a systematic review and meta-analysis". The American Journal of Medicine. 128 (6): 617–28. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.amjmed.2014.11.033">10.1016/j.amjmed.2014.11.033</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25554380">25554380</a>.</cite>

</li>

<li id="cite_note-Sullivan-NEJM-40"><a href="#cite_ref-Sullivan-NEJM_40-0">^</a> <cite id="CITEREFSullivanSwanDonnanMorrison2007" class="citation journal cs1">Sullivan FM, Swan IR, Donnan PT, Morrison JM, Smith BH, McKinstry B, et al. (October 2007). <a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMoa072006">"Early treatment with prednisolone or acyclovir in Bell's palsy"</a>. The New England Journal of Medicine. 357 (16): 1598–607. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMoa072006">10.1056/NEJMoa072006</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17942873">17942873</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:3916563">3916563</a>.</cite>

</li>

<li id="cite_note-OTC-Drops-41"><a href="#cite_ref-OTC-Drops_41-0">^</a> <cite id="CITEREFStephenson2012" class="citation web cs1">Stephenson M (October 4, 2012). <a rel="nofollow" class="external text" href="https://www.reviewofophthalmology.com/article/otc-drops-telling-the-tears-apart">"OTC Drops: Telling the Tears Apart"</a>. Review of Ophthalmology. Jobson Medical Information LLC. Retrieved April 16, 2019.</cite>

</li>

<li id="cite_note-ninds-42">^ <a href="#cite_ref-ninds_42-0">a</a> <a href="#cite_ref-ninds_42-1">b</a> <cite id="CITEREFNational_Institute_of_Neurological_Disorders_and_Stroke_(NINDS)2003" class="citation web cs1">National Institute of Neurological Disorders and Stroke (NINDS) (April 2003). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20110408004237/http://www.ninds.nih.gov/disorders/bells/detail_bells.htm">"Bell's Palsy Fact Sheet"</a>. Archived from <a rel="nofollow" class="external text" href="http://www.ninds.nih.gov/disorders/bells/detail_bells.htm">the original</a> on 8 April 2011. Retrieved 2011-05-12.</cite>

</li>

<li id="cite_note-43"><a href="#cite_ref-43">^</a> <cite id="CITEREFShafshak2006" class="citation journal cs1">Shafshak TS (March 2006). "The treatment of facial palsy from the point of view of physical and rehabilitation medicine". Europa Medicophysica. 42 (1): 41–47. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16565685">16565685</a>.</cite>

</li>

<li id="cite_note-44"><a href="#cite_ref-44">^</a> <cite id="CITEREFTeixeiraValbuzaPrado2011" class="citation journal cs1">Teixeira LJ, Valbuza JS, Prado GF (December 2011). "Physical therapy for Bell's palsy (idiopathic facial paralysis)". The Cochrane Database of Systematic Reviews (12): CD006283. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD006283.pub3">10.1002/14651858.CD006283.pub3</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22161401">22161401</a>.</cite>

</li>

<li id="cite_note-AFP2007-45">^ <a href="#cite_ref-AFP2007_45-0">a</a> <a href="#cite_ref-AFP2007_45-1">b</a> <cite id="CITEREFTiemstraKhatkhate2007" class="citation journal cs1">Tiemstra JD, Khatkhate N (October 2007). "Bell's palsy: diagnosis and management". American Family Physician. 76 (7): 997–1002. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17956069">17956069</a>.</cite>

</li>

<li id="cite_note-46"><a href="#cite_ref-46">^</a> <cite id="CITEREFMenchettiMcAllisterWalkerDonnan2021" class="citation journal cs1">Menchetti, Isabella; McAllister, Kerrie; Walker, David; Donnan, Peter T. (January 26, 2021). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094225">"Surgical interventions for the early management of Bell's palsy"</a>. The Cochrane Database of Systematic Reviews. 1 (1): CD007468. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD007468.pub4">10.1002/14651858.CD007468.pub4</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1469-493X">1469-493X</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094225">8094225</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33496980">33496980</a>.</cite>

</li>

<li id="cite_note-acupuncture-47"><a href="#cite_ref-acupuncture_47-0">^</a> <cite id="CITEREFChenZhouHeZhou2010" class="citation journal cs1">Chen N, Zhou M, He L, Zhou D, Li N (August 2010). He L (ed.). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7133542">"Acupuncture for Bell's palsy"</a>. The Cochrane Database of Systematic Reviews. 2010 (8): CD002914. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD002914.pub5">10.1002/14651858.CD002914.pub5</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7133542">7133542</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20687071">20687071</a>.</cite>

</li>

<li id="cite_note-48"><a href="#cite_ref-48">^</a> <cite id="CITEREFHollandBernsteinHamilton2012" class="citation journal cs1">Holland NJ, Bernstein JM, Hamilton JW (February 2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8406519">"Hyperbaric oxygen therapy for Bell's palsy"</a>. The Cochrane Database of Systematic Reviews. 2 (2): CD007288. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD007288.pub2">10.1002/14651858.CD007288.pub2</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8406519">8406519</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22336830">22336830</a>.</cite>

</li>

<li id="cite_note-49"><a href="#cite_ref-49">^</a> <cite id="CITEREFKarnath2013" class="citation web cs1">Karnath B (14 February 2013). <a rel="nofollow" class="external text" href="http://www.consultant360.com/article/bell-palsy-updated-guideline-treatment">"Bell Palsy: Updated Guideline for Treatment"</a>. Consultant. HMP Communications. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20130225095629/http://www.consultant360.com/article/bell-palsy-updated-guideline-treatment">Archived</a> from the original on February 25, 2013. Retrieved April 3, 2013.</cite>

</li>

<li id="cite_note-50"><a href="#cite_ref-50">^</a> <cite id="CITEREFPeitersen1982" class="citation journal cs1">Peitersen E (October 1982). "The natural history of Bell's palsy". The American Journal of Otology. 4 (2): 107–11. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/7148998">7148998</a>.</cite> quoted in <cite id="CITEREFRoobFazekasHartung1999" class="citation journal cs1">Roob G, Fazekas F, Hartung HP (January 1999). <a rel="nofollow" class="external text" href="http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=ene41003">"Peripheral facial palsy: etiology, diagnosis and treatment"</a>. European Neurology. 41 (1): 3–9. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000007990">10.1159/000007990</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/9885321">9885321</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:46877391">46877391</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20090713152309/http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=ene41003">Archived</a> from the original on 2009-07-13.</cite>

</li>

<li id="cite_note-Act_Otol_1966-51"><a href="#cite_ref-Act_Otol_1966_51-0">^</a> <cite id="CITEREFPeitersenAndersen1966" class="citation journal cs1">Peitersen E, Andersen P (June 1966). "Spontaneous course of 220 peripheral non-traumatic facial palsies". Acta Oto-Laryngologica. 63: 296–300. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3109%2F00016486709123595">10.3109/00016486709123595</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/6011525">6011525</a>.</cite>

</li>

<li id="cite_note-52"><a href="#cite_ref-52">^</a> <cite id="CITEREFYamamotoNishimuraHirono1988" class="citation journal cs1">Yamamoto E, Nishimura H, Hirono Y (1988). "Occurrence of sequelae in Bell's palsy". Acta Oto-Laryngologica. Supplementum. 446: 93–96. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3109%2F00016488709121848">10.3109/00016488709121848</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/3166596">3166596</a>.</cite>

</li>

<li id="cite_note-Ahmed-53">^ <a href="#cite_ref-Ahmed_53-0">a</a> <a href="#cite_ref-Ahmed_53-1">b</a> <cite id="CITEREFAhmed2005" class="citation journal cs1">Ahmed A (May 2005). "When is facial paralysis Bell palsy? Current diagnosis and treatment". Cleveland Clinic Journal of Medicine. 72 (5): 398–401, 405. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3949%2Fccjm.72.5.398">10.3949/ccjm.72.5.398</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15929453">15929453</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:37815525">37815525</a>.</cite>

</li>

<li id="cite_note-54"><a href="#cite_ref-54">^</a> <cite id="CITEREFWolf1998" class="citation journal cs1 cs1-prop-foreign-lang-source">Wolf SR (September 1998). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20000623213041/http://link.springer.de/link/service/journals/00106/bibs/8046009/80460786.htm">"[Idiopathic facial paralysis]"</a>. Hno (in German). 46 (9): 786–98. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs001060050314">10.1007/s001060050314</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/9816532">9816532</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:6740784">6740784</a>. Archived from <a rel="nofollow" class="external text" href="http://link.springer.de/link/service/journals/00106/bibs/8046009/80460786.htm">the original</a> on 2000-06-23.</cite>

</li>

<li id="cite_note-55"><a href="#cite_ref-55">^</a> <cite id="CITEREFMorrisDeeksHillMidroni2002" class="citation journal cs1">Morris, Andrew M.; Deeks, Shelley L.; Hill, Michael D.; Midroni, Gyl; Goldstein, Warren C.; Mazzulli, Tony; Davidson, Ross; Squires, Susan G.; Marrie, Thomas; McGeer, Allison; Low, Donald E. (September–October 2002). "Annualized Incidence and Spectrum of Illness from an Outbreak Investigation of Bell's Palsy". <a href="Neuroepidemiology_(journal)" title="Neuroepidemiology (journal)">Neuroepidemiology</a>. 21 (5): 256. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1159%2F000065645">10.1159/000065645</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12207155">12207155</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:22771896">22771896</a>.</cite>

</li>

<li id="cite_note-56"><a href="#cite_ref-56">^</a> <cite id="CITEREFSajadiSajadiTabatabaie2011" class="citation journal cs1">Sajadi MM, Sajadi MR, Tabatabaie SM (July 2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140075">"The history of facial palsy and spasm: Hippocrates to Razi"</a>. Neurology. 77 (2): 174–78. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1212%2FWNL.0b013e3182242d23">10.1212/WNL.0b013e3182242d23</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140075">3140075</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21747074">21747074</a>.</cite>

</li>

<li id="cite_note-57"><a href="#cite_ref-57">^</a> <cite id="CITEREFvan_de_GraafNicolai2005" class="citation journal cs1">van de Graaf RC, Nicolai JP (November 2005). "Bell's palsy before Bell: Cornelis Stalpart van der Wiel's observation of Bell's palsy in 1683". Otology & Neurotology. 26 (6): 1235–38. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F01.mao.0000194892.33721.f0">10.1097/01.mao.0000194892.33721.f0</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16272948">16272948</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:12630888">12630888</a>.</cite>

</li>

<li id="cite_note-58"><a href="#cite_ref-58">^</a> <cite id="CITEREFCantarellaMazzola2021" class="citation journal cs1">Cantarella, Giovanna; Mazzola, Riccardo F. (2021-07-27). "The Bicentenary of Bell's Description of the Neuroanatomical Basis of Facial Paralysis: Historical Remarks". <a href="Otolaryngology%E2%80%93Head_and_Neck_Surgery" title="Otolaryngology–Head and Neck Surgery">Otolaryngology–Head and Neck Surgery</a>. 166 (5): 907–909. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F01945998211032172">10.1177/01945998211032172</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/34314273">34314273</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:236473244">236473244</a>.</cite>

</li>

<li id="cite_note-59"><a href="#cite_ref-59">^</a> <cite class="citation news cs1"><a rel="nofollow" class="external text" href="http://news.bbc.co.uk/2/hi/americas/1042917.stm">"Jean Chretien: Veteran fighter"</a>. <a href="BBC" title="BBC">BBC</a>. November 28, 2000. Retrieved November 7, 2020.</cite>

</li>

</ol></div></div>

<div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .infobox .side-box{font-size:100%}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}

/* end https://en.wikipedia.org/ */

</style><style data-mw-deduplicate="TemplateStyles:r1237033735">

/* start https://en.wikipedia.org/ */

@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}

/* end https://en.wikipedia.org/ */

</style><div class="side-box side-box-right sistersitebox"><style data-mw-deduplicate="TemplateStyles:r1126788409">

/* start https://en.wikipedia.org/ */

.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}

/* end https://en.wikipedia.org/ */

</style>

<div class="side-box-text plainlist">Wikimedia Commons has media related to <a href="https://commons.wikimedia.org/wiki/Category:Bell%27s_palsy" class="extiw external" title="commons:Category:Bell's palsy">Bell's palsy</a>.</div></div>

</div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output .navbox-group{white-space:nowrap;text-align:right}.mw-parser-output .navbox,.mw-parser-output .navbox-subgroup{background-color:#fdfdfd}.mw-parser-output .navbox-list{line-height:1.5em;border-color:#fdfdfd}.mw-parser-output .navbox-list-with-group{text-align:left;border-left-width:2px;border-left-style:solid}.mw-parser-output tr+tr>.navbox-abovebelow,.mw-parser-output tr+tr>.navbox-group,.mw-parser-output tr+tr>.navbox-image,.mw-parser-output tr+tr>.navbox-list{border-top:2px solid #fdfdfd}.mw-parser-output .navbox-title{background-color:#ccf}.mw-parser-output .navbox-abovebelow,.mw-parser-output .navbox-group,.mw-parser-output .navbox-subgroup .navbox-title{background-color:#ddf}.mw-parser-output .navbox-subgroup .navbox-group,.mw-parser-output .navbox-subgroup .navbox-abovebelow{background-color:#e6e6ff}.mw-parser-output .navbox-even{background-color:#f7f7f7}.mw-parser-output .navbox-odd{background-color:transparent}.mw-parser-output .navbox .hlist td dl,.mw-parser-output .navbox .hlist td ol,.mw-parser-output .navbox .hlist td ul,.mw-parser-output .navbox td.hlist dl,.mw-parser-output .navbox td.hlist ol,.mw-parser-output .navbox td.hlist ul{padding:0.125em 0}.mw-parser-output .navbox .navbar{display:block;font-size:100%}.mw-parser-output .navbox-title .navbar{float:left;text-align:left;margin-right:0.5em}body.skin--responsive .mw-parser-output .navbox-image img{max-width:none!important}@media print{body.ns-0 .mw-parser-output .navbox{display:none!important}}

/* end https://en.wikipedia.org/ */

</style><style data-mw-deduplicate="TemplateStyles:r1129693374">

/* start https://en.wikipedia.org/ */

.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}

/* end https://en.wikipedia.org/ */

</style></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q1135338" class="extiw external" title="d:Q1135338">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/G51.0">G51.0</a></li><li><a href="International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=351.0">351.0</a></li><li><a href="Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D020330">D020330</a></li><li><a href="Diseases_Database" title="Diseases Database">DiseasesDB</a>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb1303.htm">1303</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="MedlinePlus" title="MedlinePlus">MedlinePlus</a>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000773.htm">000773</a></li><li><a href="EMedicine" title="EMedicine">eMedicine</a>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/emerg/56-overview">emerg/56</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/neuro/topic413.htm#">neuro/413</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/ent/topic719.htm#">ent/719</a> <a rel="nofollow" class="external text" href="https://www.emedicine.com/oph/topic508.htm#">oph/508</a></li><li><a href="Patient_UK" title="Patient UK">Patient UK</a>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/facial-nerve-palsy">Bell's palsy</a></li></ul></div></div></td></tr></tbody></table></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}

/* end https://en.wikipedia.org/ */

</style><div id="Diseases_relating_to_the_peripheral_nervous_system54" style="font-size:114%;margin:0 4em">Diseases relating to the <a href="Peripheral_nervous_system" title="Peripheral nervous system">peripheral nervous system</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible uncollapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2" style="padding-left: 0.5em; padding-right: 0.75em;"><div id="Mononeuropathy54" style="font-size:114%;margin:0 4em"><a href="Mononeuropathy" class="mw-redirect" title="Mononeuropathy">Mononeuropathy</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Arm</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Median_nerve" title="Median nerve">median nerve</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Carpal_tunnel_syndrome" title="Carpal tunnel syndrome">Carpal tunnel syndrome</a></li>

<li><a href="Ape_hand_deformity" title="Ape hand deformity">Ape hand deformity</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Ulnar_nerve" title="Ulnar nerve">ulnar nerve</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Ulnar_nerve_entrapment" class="mw-redirect" title="Ulnar nerve entrapment">Ulnar nerve entrapment</a></li>

<li><a href="Froment's_sign" class="mw-redirect" title="Froment's sign">Froment's sign</a></li>

<li><a href="Ulnar_tunnel_syndrome" title="Ulnar tunnel syndrome">Ulnar tunnel syndrome</a></li>

<li><a href="Ulnar_claw" title="Ulnar claw">Ulnar claw</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Radial_nerve" title="Radial nerve">radial nerve</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Radial_neuropathy" title="Radial neuropathy">Radial neuropathy</a></li>

<li><a href="Wrist_drop" title="Wrist drop">Wrist drop</a></li>

<li><a href="Cheiralgia_paresthetica" title="Cheiralgia paresthetica">Cheiralgia paresthetica</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Long_thoracic_nerve" title="Long thoracic nerve">long thoracic nerve</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Winged_scapula" title="Winged scapula">Winged scapula</a></li>

<li><a href="Brachial_plexus_injury" title="Brachial plexus injury">Backpack palsy</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Leg</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Lateral_cutaneous_nerve_of_thigh" title="Lateral cutaneous nerve of thigh">lateral cutaneous nerve of thigh</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Meralgia_paraesthetica" title="Meralgia paraesthetica">Meralgia paraesthetica</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Tibial_nerve" title="Tibial nerve">tibial nerve</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Tarsal_tunnel_syndrome" title="Tarsal tunnel syndrome">Tarsal tunnel syndrome</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Plantar_nerve" title="Plantar nerve">plantar nerve</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Morton's_neuroma" title="Morton's neuroma">Morton's neuroma</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Superior_gluteal_nerve" title="Superior gluteal nerve">superior gluteal nerve</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Trendelenburg's_sign" title="Trendelenburg's sign">Trendelenburg's sign</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Sciatic_nerve" title="Sciatic nerve">sciatic nerve</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Piriformis_syndrome" title="Piriformis syndrome">Piriformis syndrome</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Cranial_nerve_disease" title="Cranial nerve disease">Cranial nerves</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li>See Template:Cranial nerve disease</li></ul>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible uncollapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2" style="padding-left: 0.5em; padding-right: 0.75em;"><div id="Polyneuropathy_and_Polyradiculoneuropathy54" style="font-size:114%;margin:0 4em"><a href="Polyneuropathy" title="Polyneuropathy">Polyneuropathy</a> and <a href="Polyradiculoneuropathy" title="Polyradiculoneuropathy">Polyradiculoneuropathy</a></div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Hereditary_motor_and_sensory_neuropathy" title="Hereditary motor and sensory neuropathy">HMSN</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Charcot%E2%80%93Marie%E2%80%93Tooth_disease" title="Charcot–Marie–Tooth disease">Charcot–Marie–Tooth disease</a></li>

<li><a href="Dejerine%E2%80%93Sottas_disease" title="Dejerine–Sottas disease">Dejerine–Sottas disease</a></li>

<li><a href="Refsum_disease" title="Refsum disease">Refsum's disease</a></li>

<li><a href="Hereditary_spastic_paraplegia" title="Hereditary spastic paraplegia">Hereditary spastic paraplegia</a></li>

<li><a href="Hereditary_neuropathy_with_liability_to_pressure_palsy" title="Hereditary neuropathy with liability to pressure palsy">Hereditary neuropathy with liability to pressure palsy</a></li>

<li><a href="Familial_amyloid_neuropathy" title="Familial amyloid neuropathy">Familial amyloid neuropathy</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Autoimmunity" title="Autoimmunity">Autoimmune</a> and <a href="Demyelinating_disease" title="Demyelinating disease">demyelinating disease</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Guillain%E2%80%93Barr%C3%A9_syndrome" title="Guillain–Barré syndrome">Guillain–Barré syndrome</a></li>

<li><a href="Chronic_inflammatory_demyelinating_polyneuropathy" title="Chronic inflammatory demyelinating polyneuropathy">Chronic inflammatory demyelinating polyneuropathy</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Radiculopathy" title="Radiculopathy">Radiculopathy</a> and <a href="Plexopathy" title="Plexopathy">plexopathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Brachial_plexus_injury" title="Brachial plexus injury">Brachial plexus injury</a></li>

<li><a href="Pectoralis_minor_syndrome" title="Pectoralis minor syndrome">Pectoralis minor syndrome</a></li>

<li><a href="Thoracic_outlet_syndrome" title="Thoracic outlet syndrome">Thoracic outlet syndrome</a></li>

<li><a href="Phantom_limb" title="Phantom limb">Phantom limb</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Alcoholic_polyneuropathy" title="Alcoholic polyneuropathy">Alcoholic polyneuropathy</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks mw-collapsible uncollapsed navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="col" class="navbox-title" colspan="2" style="padding-left: 0.5em; padding-right: 0.75em;"><div id="Other54" style="font-size:114%;margin:0 4em">Other</div></th></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">General</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Complex_regional_pain_syndrome" title="Complex regional pain syndrome">Complex regional pain syndrome</a></li>

<li><a href="Mononeuritis_multiplex" class="mw-redirect" title="Mononeuritis multiplex">Mononeuritis multiplex</a></li>

<li><a href="Nerve_compression_syndrome" title="Nerve compression syndrome">Nerve compression syndrome</a></li>

<li><a href="Neuralgia" title="Neuralgia">Neuralgia</a></li>

<li><a href="Peripheral_neuropathy" title="Peripheral neuropathy">Peripheral neuropathy</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr></tbody></table></div></div><div><div class="zim-footer">

This article is issued from <a class="external text" title="Last edited on 2025-07-17" href="https://en.wikipedia.org/wiki/?title=Bell's_palsy&oldid=1301015237">Wikipedia</a>. The text is available under <a class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.en">Creative Commons Attribution-Share Alike 4.0</a> unless otherwise noted. Additional terms may apply for the media files.

</div>

</div></div>

</div>

</main>

</div>

</body></html>