First Canadian Bell palsy guideline

The first Canadian guideline for Bell palsy, facial weakness or paralysis caused by facial nerve damage, is aimed at helping physicians manage and treat patients during the acute phase as well as recovery. The guideline, published in CMAJ (Canadian Medical Association Journal), is based on the growing body of recent evidence on the condition.

Bell palsy is damage to the that results in sudden weakness or of one side of the face. It can come on suddenly with symptoms such as drooping of the face and eyelids, twitching, and others that may include mild or total paralysis.

"Although many patients with Bell palsy will experience improvement in their facial nerve function without treatment, persistent facial weakness can have implications for quality of life," writes Dr. John de Almeida and members of the Bell Palsy Working Group. "Choosing the correct treatment options for suitable patients can optimize the likelihood of recovery."

People with mild paralysis have higher rates of recovery than those who are severely affected. Because about 1 in 60 people will be affected over the course of their lifetime, it is important for to know how to manage this illness.

"Establishing the correct diagnosis is imperative to avoid missing another treatable condition," write the authors.

Key recommendations:

  • corticosteroids for all patients with Bell palsy to help reduce involuntary facial spasms
  • combined use of antivirals and corticosteroids in patients with severe to complete paralysis but not in patients with mild to moderate paralysis
  • no antiviral treatment alone
  • for patients who do not improve or whose symptoms worsen, referral to a specialist
  • imaging for patients who do not improve to determine if there are other causes of the weakness.

The guideline is neutral on whether physiotherapy is effective for acute weakness, but it suggests that it may help patients with persistent weakness.

"The guideline was timely given recent meta-analyses of data and recent RCTs [randomized controlled trials]," says Dr. de Almeida. "We hope this new guideline will help physicians in Canada and beyond manage Bell palsy ."

More information: www.cmaj.ca/lookup/doi/10.1503/cmaj.131801

add to favorites email to friend print save as pdf

Related Stories

AAO-HNSF clinical practice guideline: Bell's palsy

Nov 04, 2013

A multidisciplinary clinical practice guideline to improve the accurate and efficient diagnosis and treatment of Bell's palsy was published Monday in the journal Otolaryngology–Head and Neck Surgery. The guideline is int ...

Recommended for you

Cerebral palsy may be hereditary

3 hours ago

Cerebral palsy is a neurological developmental disorder which follows an injury to the immature brain before, during or after birth. The resulting condition affects the child's ability to move and in some ...

19 new dengue cases in Japan, linked to Tokyo park

9 hours ago

Japan is urging local authorities to be on the lookout for further outbreaks of dengue fever, after confirming another 19 cases that were contracted at a popular local park in downtown Tokyo.

User comments