First Canadian Bell palsy guideline

June 16, 2014

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 ."

Explore further: AAO-HNSF clinical practice guideline: Bell's palsy

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

Related Stories

AAO-HNSF clinical practice guideline: Bell's palsy

November 4, 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 intended ...

Guideline: Steroid pills effective for treating facial paralysis in Bell's palsy

November 7, 2012
For people experiencing first-time symptoms of Bell's palsy, steroid pills very likely are the most effective known treatment for recovering full strength in the facial muscles, according to a guideline published in the November ...

Research examines effect of prednisolone in patients with Bell palsy

May 21, 2012
Treatment for Bell palsy (a condition involving the facial nerve and characterized by facial paralysis) with the corticosteroid prednisolone within 72 hours appeared to significantly reduce the number of patients with mild ...

Is it Bell's palsy or a stroke? Emergency physicians have the answer

July 26, 2013
Emergency physicians correctly identified nearly 100 percent of patients with Bell's palsy, the symptoms of which are nearly identical to potentially life-threatening diseases such as stroke and brain tumors. The results ...

Intense acupuncture can improve muscle recovery in patients with Bell palsy

February 25, 2013
Patients with Bell palsy who received acupuncture that achieves de qi, a type of intense stimulation, had improved facial muscle recovery, reduced disability and better quality of life, according to a randomized controlled ...

Recommended for you

Google searches can be used to track dengue in underdeveloped countries

July 20, 2017
An analytical tool that combines Google search data with government-provided clinical data can quickly and accurately track dengue fever in less-developed countries, according to new research published in PLOS Computational ...

MRSA emerged years before methicillin was even discovered

July 19, 2017
Methicillin resistant Staphylococcus aureus (MRSA) emerged long before the introduction of the antibiotic methicillin into clinical practice, according to a study published in the open access journal Genome Biology. It was ...

New test distinguishes Zika from similar viral infections

July 18, 2017
A new test is the best-to-date in differentiating Zika virus infections from infections caused by similar viruses. The antibody-based assay, developed by researchers at UC Berkeley and Humabs BioMed, a private biotechnology ...

'Superbugs' study reveals complex picture of E. coli bloodstream infections

July 18, 2017
The first large-scale genetic study of Escherichia coli (E. coli) cultured from patients with bloodstream infections in England showed that drug resistant 'superbugs' are not always out-competing other strains. Research by ...

Ebola virus can persist in monkeys that survived disease, even after symptoms disappear

July 17, 2017
Ebola virus infection can be detected in rhesus monkeys that survive the disease and no longer show symptoms, according to research published by Army scientists in today's online edition of the journal Nature Microbiology. ...

Mountain gorillas have herpes virus similar to that found in humans

July 13, 2017
Scientists from the University of California, Davis, have detected a herpes virus in wild mountain gorillas that is very similar to the Epstein-Barr virus in humans, according to a study published today in the journal Scientific ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.