Bell’s palsy

Clinical pathology of Bell’s palsy is severity in a given case varies from simple conduction block to severe axonal degeneration. Clinical features are onset is acute, sometimes history of exposure to cold is present .Mild pain at atylomastoid foramen for a few days precede the palsy. Examination shows isolated lower motor neuron facial paralysis with or without loss of taste sensation at anterior two-third of tongue and hyperacusis. Some features of lower motor facial nerve palsy are paralysis of all the muscles of facial expression on the side of skin, drooping of corner of mouth, effacement of creases and skin fold on the affected side, weakness of frowning and eye closure since the upper facial muscles are weak, drooling of saliva from angle of mouth, on asking patient to show his teeth, the angle of mouth deviates away from the side of lesion, corneal ulceration due to inability to close the eye during sleep. Differential diagnosis of Bell’s palsy is herpe zoster of 7th nerve, middle ear disease with 7 th nerve compression, trauma, and diabetic mononeropathy. Investigations of Bell’s palsy are no specific confirmatory diagnostic procedure .It can be treated by adhesive tape to keep the eye closed so as to prevent corneal ulceration