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Bell Palsy
H. Ric Harnsberger, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Bell palsy (BP)
            • Synonyms

              • Herpetic facial paralysis
            • Definitions

              • BP (original definition): Idiopathic acute onset of lower motor neuron facial paralysis
              • BP (modern definition): Herpetic facial paralysis secondary to herpes simplex virus
            • Other Facts

              • Named after Sir Charles Bell (1774-1842), who 1st described BP syndrome

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Hohman MH et al: Etiology, diagnosis, and management of facial palsy: 2000 patients at a facial nerve center. Laryngoscope. 124(7):E283-93, 2014
                                          2. Vianna M et al: Differences in the diameter of facial nerve and facial canal in bell's palsy--a 3-dimensional temporal bone study. Otol Neurotol. 35(3):514-8, 2014
                                          3. Zandian A et al: The neurologist's dilemma: a comprehensive clinical review of Bell's palsy, with emphasis on current management trends. Med Sci Monit. 20:83-90, 2014
                                          4. Baugh RF et al: Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg. 149(3 Suppl):S1-27, 2013
                                          5. Song MH et al: Clinical significance of quantitative analysis of facial nerve enhancement on MRI in Bell's palsy. Acta Otolaryngol. 128(11):1259-65, 2008
                                          6. Yeo SG et al: Acyclovir plus steroid vs steroid alone in the treatment of Bell's palsy. Am J Otolaryngol. 29(3):163-6, 2008
                                          7. Kim IS et al: Correlation between MRI and operative findings in Bell's palsy and Ramsay Hunt syndrome. Yonsei Med J. 48(6):963-8, 2007
                                          8. Sullivan FM et al: Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med. 357(16):1598-607, 2007
                                          9. Kress B et al: Bell palsy: quantitative analysis of MR imaging data as a method of predicting outcome. Radiology. 230(2):504-9, 2004
                                          10. Unlu Z et al: Serologic examinations of hepatitis, cytomegalovirus, and rubella in patients with Bell's palsy. Am J Phys Med Rehabil. 82(1):28-32, 2003
                                          11. Kress BP et al: Bell's palsy: what is the prognostic value of measurements of signal intensity increases with contrast enhancement on MRI? Neuroradiology. 44(5):428-33, 2002
                                          12. Suzuki F et al: Herpes virus reactivation and gadolinium-enhanced magnetic resonance imaging in patients with facial palsy. Otol Neurotol. 22(4):549-53, 2001
                                          13. Engstrom M et al: Serial gadolinium-enhanced magnetic resonance imaging and assessment of facial nerve function in Bell's palsy. Otolaryngol Head Neck Surg. 117(5):559-66, 1997
                                          14. Adour KK: Medical management of idiopathic (Bell's) palsy. Otolaryngol Clin North Am. 24(3):663-73, 1991
                                          15. Schwaber MK et al: Gadolinium-enhanced magnetic resonance imaging in Bell's palsy. Laryngoscope. 100(12):1264-9, 1990
                                          16. Tien R et al: Contrast-enhanced MR imaging of the facial nerve in 11 patients with Bell's palsy. AJNR Am J Neuroradiol. 11(4):735-41, 1990
                                          17. Daniels DL et al: MR imaging of facial nerve enhancement in Bell palsy or after temporal bone surgery. Radiology. 171(3):807-9, 1989
                                          18. Matsumoto Y et al: Facial nerve biopsy for etiologic clarification of Bell's palsy. Ann Otol Rhinol Laryngol Suppl. 137:22-7, 1988
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Bell palsy (BP)
                                                    • Synonyms

                                                      • Herpetic facial paralysis
                                                    • Definitions

                                                      • BP (original definition): Idiopathic acute onset of lower motor neuron facial paralysis
                                                      • BP (modern definition): Herpetic facial paralysis secondary to herpes simplex virus
                                                    • Other Facts

                                                      • Named after Sir Charles Bell (1774-1842), who 1st described BP syndrome

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Hohman MH et al: Etiology, diagnosis, and management of facial palsy: 2000 patients at a facial nerve center. Laryngoscope. 124(7):E283-93, 2014
                                                                                  2. Vianna M et al: Differences in the diameter of facial nerve and facial canal in bell's palsy--a 3-dimensional temporal bone study. Otol Neurotol. 35(3):514-8, 2014
                                                                                  3. Zandian A et al: The neurologist's dilemma: a comprehensive clinical review of Bell's palsy, with emphasis on current management trends. Med Sci Monit. 20:83-90, 2014
                                                                                  4. Baugh RF et al: Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg. 149(3 Suppl):S1-27, 2013
                                                                                  5. Song MH et al: Clinical significance of quantitative analysis of facial nerve enhancement on MRI in Bell's palsy. Acta Otolaryngol. 128(11):1259-65, 2008
                                                                                  6. Yeo SG et al: Acyclovir plus steroid vs steroid alone in the treatment of Bell's palsy. Am J Otolaryngol. 29(3):163-6, 2008
                                                                                  7. Kim IS et al: Correlation between MRI and operative findings in Bell's palsy and Ramsay Hunt syndrome. Yonsei Med J. 48(6):963-8, 2007
                                                                                  8. Sullivan FM et al: Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med. 357(16):1598-607, 2007
                                                                                  9. Kress B et al: Bell palsy: quantitative analysis of MR imaging data as a method of predicting outcome. Radiology. 230(2):504-9, 2004
                                                                                  10. Unlu Z et al: Serologic examinations of hepatitis, cytomegalovirus, and rubella in patients with Bell's palsy. Am J Phys Med Rehabil. 82(1):28-32, 2003
                                                                                  11. Kress BP et al: Bell's palsy: what is the prognostic value of measurements of signal intensity increases with contrast enhancement on MRI? Neuroradiology. 44(5):428-33, 2002
                                                                                  12. Suzuki F et al: Herpes virus reactivation and gadolinium-enhanced magnetic resonance imaging in patients with facial palsy. Otol Neurotol. 22(4):549-53, 2001
                                                                                  13. Engstrom M et al: Serial gadolinium-enhanced magnetic resonance imaging and assessment of facial nerve function in Bell's palsy. Otolaryngol Head Neck Surg. 117(5):559-66, 1997
                                                                                  14. Adour KK: Medical management of idiopathic (Bell's) palsy. Otolaryngol Clin North Am. 24(3):663-73, 1991
                                                                                  15. Schwaber MK et al: Gadolinium-enhanced magnetic resonance imaging in Bell's palsy. Laryngoscope. 100(12):1264-9, 1990
                                                                                  16. Tien R et al: Contrast-enhanced MR imaging of the facial nerve in 11 patients with Bell's palsy. AJNR Am J Neuroradiol. 11(4):735-41, 1990
                                                                                  17. Daniels DL et al: MR imaging of facial nerve enhancement in Bell palsy or after temporal bone surgery. Radiology. 171(3):807-9, 1989
                                                                                  18. Matsumoto Y et al: Facial nerve biopsy for etiologic clarification of Bell's palsy. Ann Otol Rhinol Laryngol Suppl. 137:22-7, 1988