Facial nerve paralysis. 1. General evaluation, Bell's palsy.

The correct diagnosis of facial paralysis is not easily made but is important for proper management, since such paralysis is a sign or symptom of an underlying disorder. The clinician must be able to make an accurate and complete assessment of the entire facial nerve. Once a diagnosis is made, information from the history and results of topographic and electrical testing can be used in planning management and treatment. Bell's palsy, which is idiopathic, is the most common cause of facial paralysis. It is acute in onset and can come from a variety of causes. In the large majority of patients, the condition resolves either spontaneously or with treatment. Currently available treatments include corticosteroid therapy and facial nerve decompression, although both remain controversial.