Bell's Palsy: A Neurological Point of View

"Abducens Nerve and Facial Nerve Palsy in the Setting of an Extracranial Mass and Vascular Disease"

“…The facial nerve has a robust vascular supply due to its thick epineurium; this vascular dependency proposes an ischemic connection to facial nerve palsy [7]. Although the facial nerve vascular supply has many anastomoses, this system can be compromised by diabetes mellitus, which is present in this case, especially at certain points along its tract that do have as proficient collateral perfusion as in the stylomastoid and petrosal branches [8]. Concurrent abducens and facial nerve palsies are a very uncommon finding.…”

Bell’s Palsy—Unclear Terminology and Definitions Impede Progress

“…The most common descriptors characterizing BP were “idiopathic,” “peripheral,” and “acute,” followed by less common descriptors, such as “diagnosis of exclusion.” Interestingly, 18 articles described BP as a “polyneuropathy,” most commonly defining it as part of a mononeuritis multiplex. 39–41 Articles also demonstrated inconsistency in their ascribed etiologies. The most common specified etiology was infectious, including HSV-1 or non-herpetic infection, such as Borrelia burgdorferi , the bacterial cause of facial palsy in Lyme disease.…”

Bell’s Palsy-Tertiary Ischemia: An Etiological Factor in Residual Facial Palsy

“…And opponents of this theory would state that the nerve has adequate blood supply with numerous anastomoses between the stylomastoid and petrosal vessels. However in certain cases, such as in Leriche's syndrome and possibly Diabetes mellitus [1] such a mechanism could apply. It is certainly possible, as is witnessed by the onset of acute facial paralysis following the embolisation of the middle meningeal artery [2].…”