Differential Diagnosis of Facial Nerve Palsy

May, Mark; Klein, Susan R.

doi:10.1016/s0030-6665(20)31118-x

Cited by 121 publications

(64 citation statements)

References 77 publications

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“…The patient is usually labelled as Bell's even though there could be other underlying causes of facial palsy. 4 In a series of 2856 cases of acute facial palsy, only 51 per cent of the cases were due to Bell's palsy. 4 The reported incidence of misdiagnosis of unilateral facial palsy as Bell's palsy ranges between 13 and 20 per cent in all referred cases of peripheral palsy.…”

Section: Resultsmentioning

confidence: 99%

“…4 In a series of 2856 cases of acute facial palsy, only 51 per cent of the cases were due to Bell's palsy. 4 The reported incidence of misdiagnosis of unilateral facial palsy as Bell's palsy ranges between 13 and 20 per cent in all referred cases of peripheral palsy. 4,13 In one study of 1675 patients referred for acute facial palsy, 224 cases had a different aetiology.…”

Section: Resultsmentioning

confidence: 99%

“…2,3 The other main causes of facial palsy include trauma, herpes zoster, neoplasm, infection and congenital anomalies. 4 Since the majority of cases of unilateral facial palsy are idiopathic, it is not uncommon to miss other underlying lesions. Therefore it is essential to exclude other causes of facial palsy before making a definitive diagnosis.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore it is essential to exclude other causes of facial palsy before making a definitive diagnosis. 2,4,5 The accurate evaluation of facial palsy, with early recognition of signs and symptoms inconsistent with Bell's palsy, is crucial to avoid misdiagnosis of facial palsy. 5 Every patient with facial palsy should have a complete neurological examination, 6 and repeated assessments are required to detect signs that may not present initially.…”

Section: Introductionmentioning

confidence: 99%

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An analysis of diagnostic delay in unilateral facial paralysis

et al. 2005

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Bell's palsy or idiopathic facial palsy is the commonest cause of unilateral lower motor neuron facial palsy. Misdiagnosis of facial nerve palsy as Bell's palsy is still seen in clinical practice. The clinician should always consider the possibility of a potentially serious underlying pathology before making the diagnosis of Bell's palsy. We present a series of 13 patients referred to our ENT department with an initial diagnosis of Bell's palsy. Further clinical examination and investigation revealed the underlying cause. Many had additional symptoms and signs related to the ear. In all patients with unilateral facial palsy a detailed history should be taken and thorough clinical examination carried out. Where no recovery occurs within the expected time period further radiological investigations such as computerized axial tomography (CT) and magnetic resonance imaging (MRI) should be performed. Current scanning techniques provide good quality images, which can show occult lesions of the temporal bone, internal acoustic canal and/or cerebellopontine angle. Radiologists with a special interest and experience in otoneurological radiology should ideally report these images, and a close co-operation between ENT surgeon and radiologist is essential in arriving at a proper diagnosis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An analysis of diagnostic delay in unilateral facial paralysis

et al. 2005

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“…In neonates, birth trauma is the commonest cause and complete recovery occurs in the majority of cases 2 Table IAetiology of facial palsyAdapted with permission 1 , 2 . *Cortical lesion in facial motor area.…”

Section: Aetiologymentioning

confidence: 99%