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- Bell Palsy is the most common cause of unilateral facial weakness.
- It is caused by edema and ischemia causing compression of the facial nerve (cranial nerve seven).
- While Bell Palsy is by definition an idiopathic facial palsy, the etiology is often infact discovered and attributed to conditions such as Lyme Disease, Herpes Simplex Virus, and HIV.
- Classic symptoms of Bell Palsy include:
-- acute onset of unilateral upper and lower facial paralysis (over 48 hr. period)
-- posterior auricular pain
-- decreased tearing
-- hyperacusis (due to stapedius muscle weakness)
-- taste disturbances
- Bell Palsy is a diagnosis of exclusion. If the facial paralysis is isolated to the lower face, if there is associated contralateral weakness, and/or if there is diplopia, a central cause for the symptoms, rather than Bell Palsy, must be strongly considered.