Bells palsy

G51.0

DESCRIPTION

Unilateral paralysis of all the muscles of facial expression (the corner of the mouth drops, the forehead is unfurrowed, and the eyelids will not close).

Taste sensation may be lost unilaterally and hyperacusis (painful sensitivity to loud sounds) may be present.
Most patients recover within a few weeks or months.

GENERAL MEASURES

  • HIV testing.
  • Referral for facial muscle massage and exercises.
  • Eye patch for protection of the eye during sleep.

MEDICINE TREATMENT

Adults LoEIII [15]

  • Corticosteroids (intermediate-acting) e.g.:
  • Prednisone, oral, 60 mg daily for 7 days started within 72 hours, preferably within 48 hours of onset (Doctor prescribed).

LoEI[16]

Children

  • Corticosteroids (intermediate-acting) e.g.:
  • Prednisone, oral, 2 mg/kg daily for 7 days within 3 days of onset (Doctor prescribed).

LoE111[17]

Weight
Kg 		Dose
Mg 		Tablet
5 mg 		Age
Months/years
>17.5–25 kg 40 mg 8 tablets >5–7 years
>25–40 kg 55 mg 11 tablets >7–12 years

REFERRAL

  • If diagnosis uncertain.
  • All cases for physiotherapy, if available.
  • Eye irritation requiring lubrication.