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bell's palsy guideline

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1. Management of Bell palsy: clinical practice guideline

Management of Bell palsy: clinical practice guideline B ell palsy is an idiopathic weakness or paralysis of the face of peripheral nerve origin, with acute onset. It affects 20–30 persons per 100 000 annually, and 1 in 60 indi- viduals will be affected over the course of their lifetime. 1,2 The major cause of Bell palsy is believed to be an infection of the facial nerve by the herpes simplex virus. 3 As a result of this viral infection, the facial nerve swells and is compressed in its canal (...) and permanent visual impairment. Those with resid- ual deficits may have long-term reduction in quality of life and psychological distress. 8 In this guideline, we review the evidence for treatment of Bell palsy with corticosteroids and antivirals, facial exercise, electrostimulation, physiotherapy and decompression surgery, as well as the need for eye-protective measures, spe- cialist referral and further investigation in patients with persistent and progressive weakness. This guideline is aimed at all

2014 CPG Infobase

2. Corticosteroids improve recovery rates after Bell’s palsy

receiving corticosteroids (RR 0.64, 95% CI 0.45 to 0.91) three studies. Three studies specifically noted that there were no side effects that were caused by the corticosteroids. Combined data from three studies that recorded non-serious side effects showed no difference in rates between people taking corticosteroids and those taking placebo (RR 1.04, 95% CI 0.71 to 1.51). What does current guidance say on this issue? There is no national clinical guideline on the management of Bell’s palsy. Clinical (...) in participants receiving corticosteroids (RR 0.64, 95% CI 0.45 to 0.91) three studies. Three studies specifically noted that there were no side effects that were caused by the corticosteroids. Combined data from three studies that recorded non-serious side effects showed no difference in rates between people taking corticosteroids and those taking placebo (RR 1.04, 95% CI 0.71 to 1.51). What does current guidance say on this issue? There is no national clinical guideline on the management of Bell’s palsy

2019 NIHR Dissemination Centre

3. Corticosteroids improve recovery rates after Bell’s palsy

receiving corticosteroids (RR 0.64, 95% CI 0.45 to 0.91) three studies. Three studies specifically noted that there were no side effects that were caused by the corticosteroids. Combined data from three studies that recorded non-serious side effects showed no difference in rates between people taking corticosteroids and those taking placebo (RR 1.04, 95% CI 0.71 to 1.51). What does current guidance say on this issue? There is no national clinical guideline on the management of Bell’s palsy. Clinical (...) in participants receiving corticosteroids (RR 0.64, 95% CI 0.45 to 0.91) three studies. Three studies specifically noted that there were no side effects that were caused by the corticosteroids. Combined data from three studies that recorded non-serious side effects showed no difference in rates between people taking corticosteroids and those taking placebo (RR 1.04, 95% CI 0.71 to 1.51). What does current guidance say on this issue? There is no national clinical guideline on the management of Bell’s palsy

2018 NIHR Dissemination Centre

4. Pharmacologic Interventions for Bell's Palsy

Pharmacologic Interventions for Bell's Palsy Pharmacologic Interventions for Bell's Palsy | National Guideline Clearinghouse success fail JUL Aug 12 2018 2019 30 Sep 2016 - 14 Jul 2018 COLLECTED BY Organization: Formed in 2009, the Archive Team (not to be confused with the archive.org Archive-It Team) is a rogue archivist collective dedicated to saving copies of rapidly dying or deleted websites for the sake of history and digital heritage. The group is 100% composed of volunteers (...) * Remember Me Don't have an account? The AHRQ National Guideline Clearinghouse (NGC, guideline.gov) Web site will not be available after July 16, 2018 because federal funding through AHRQ will no longer be available to support the NGC as of that date. For additional information, read our . Guideline Synthesis Pharmacologic Interventions for Bell's Palsy Guidelines Being Compared: American Academy of Neurology (Am Acad Neurol) Evidence-based guideline update: steroids and antivirals for Bell palsy: report

2014 National Guideline Clearinghouse (partial archive)

5. Intratympanic Steroid for Bell's Palsy

first. Condition or disease Intervention/treatment Phase Bell's Palsy Facial Nerve Paresis Procedure: Intratympanic injection Drug: Prednisone Phase 2 Phase 3 Detailed Description: Facial nerve paralysis is due to inflammation surrounding the facial nerve. Current clinical practice guidelines for treatment of facial nerve paralysis recommend a 10 day course of oral steroids +/- oral acyclovir. Treatment should begin within 72 hours of symptom onset. In patients with complete facial paralysis (...) Intratympanic Steroid for Bell's Palsy Intratympanic Steroid for Bell's Palsy - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Intratympanic Steroid for Bell's Palsy The safety and scientific validity

2018 Clinical Trials

6. Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society. (PubMed)

Photographic Standards for Patients With Facial Palsy and Recommendations by Members of the Sir Charles Bell Society. There is no widely accepted assessment tool or common language used by clinicians caring for patients with facial palsy, making exchange of information challenging. Standardized photography may represent such a language and is imperative for precise exchange of information and comparison of outcomes in this special patient population.To review the literature to evaluate the use (...) of facial photography in the management of patients with facial palsy and to examine the use of photography in documenting facial nerve function among members of the Sir Charles Bell Society-a group of medical professionals dedicated to care of patients with facial palsy.A literature search was performed to review photographic standards in patients with facial palsy. In addition, a cross-sectional survey of members of the Sir Charles Bell Society was conducted to examine use of medical photography

Full Text available with Trip Pro

2017 JAMA facial plastic surgery

7. Bell's palsy

Bell's palsy Clinical Practice Guideline: Bell’s Palsy - Reginald F. Baugh, Gregory J. Basura, Lisa E. Ishii, Seth R. Schwartz, Caitlin Murray Drumheller, Rebecca Burkholder, Nathan A. Deckard, Cindy Dawson, Colin Driscoll, M. Boyd Gillespie, Richard K. Gurgel, John Halperin, Ayesha N. Khalid, Kaparaboyna Ashok Kumar, Alan Micco, Debra Munsell, Steven Rosenbaum, William Vaughan, 2013 MENU IN THIS JOURNAL Sign In Institution Society Access Options You can be signed in via any or all (...) Guideline: Bell’s Palsy .entryAuthor" data-author-container-selector=".NLM_contrib-group"> Show all authors , MD 1 1University of Toledo Medical Center, Toledo, Ohio, USA by this author for this author , , MD, PhD 2 2University of Michigan, Ann Arbor, Michigan, USA by this author for this author , , MD, MHS 3 3Johns Hopkins University, Baltimore, Maryland, USA by this author for this author , , MD, MPH 4 4Virginia Mason Medical Center, Seattle, Washington, USA by this author for this author , 5

2013 American Academy of Otolaryngology - Head and Neck Surgery

8. Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell´s palsy: review of guidelines for refractory facial nerve palsy (PubMed)

Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell´s palsy: review of guidelines for refractory facial nerve palsy Bell´s palsy is the most common cause of facial paralysis worldwide and the most common disorder of the cranial nerves. It is a diagnosis of exclusion, accounting for 60-75% of all acquired peripheral facial nerve palsies. Our case shows the first case of a microcystic adnexal carcinoma-like squamous cell carcinoma as a cause (...) of facial nerve palsy.The patient, a 70-year-old Caucasian male, experienced subsequent functional impairment of the trigeminal and the glossopharyngeal nerve about 1½ years after refractory facial nerve palsy. An extensive clinical work-up and tissue biopsy of the surrounding parotid gland tissue was not able to determine the cause of the paralysis. Primary infiltration of the facial nerve with subsequent spreading to the trigeminal and glossopharyngeal nerve via neuroanastomoses was suspected. After

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2017 Journal of Otolaryngology - Head & Neck Surgery

9. Facial Palsy

Facial Palsy Facial palsy (Bell’s Palsy) submit The College submit You're here: Facial palsy (Bell’s Palsy) Facial palsy (Bell’s Palsy) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Please login to view the images or Aetiology Paralysis of facial nerve (VII cranial nerve) This Clinical Management Guideline addresses Bell’s Palsy (idiopathic (...) therapy (with or without anti-viral) most improvement occurs within three weeks Other causes of paralysis of the facial nerve, which are not addressed in this Clinical Management Guideline, include: infection, e.g. otitis media trauma, e.g. temporal bone fracture tumour compressing the facial nerve, e.g. acoustic neuroma sarcoidosis Guillain-Barré syndrome cerebrovascular accident (stroke) Predisposing factors Bell’s Palsy is more common in: pregnancy (annual incidence increases to 45 per 100,000

2018 College of Optometrists

10. Bell's palsy: aetiology, clinical features and multidisciplinary care. (PubMed)

along with in vitro studies of virus-axon interactions. Recently published guidelines for the acute treatment of Bell's palsy advocate for steroid monotherapy, although controversy exists over whether combined corticosteroids and antivirals may possibly have a beneficial role in select cases of severe Bell's palsy. For those with longstanding sequaelae from incomplete recovery, aesthetic, functional (nasal patency, eye closure, speech and swallowing) and psychological considerations need (...) Bell's palsy: aetiology, clinical features and multidisciplinary care. Bell's palsy is a common cranial neuropathy causing acute unilateral lower motor neuron facial paralysis. Immune, infective and ischaemic mechanisms are all potential contributors to the development of Bell's palsy, but the precise cause remains unclear. Advancements in the understanding of intra-axonal signal molecules and the molecular mechanisms underpinning Wallerian degeneration may further delineate its pathogenesis

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2015 Neurosurgery and Psychiatry

11. [The new S2k AWMF guideline for the treatment of Bell's palsy in commented short form].

[The new S2k AWMF guideline for the treatment of Bell's palsy in commented short form]. A new S2k AWMF guideline for the treatment of idiopathic facial palsy has been published. An accurate differential diagnosis is indispensable as 25-40% of all facial palsy cases are of non-idiopathic origin. It is explicitly recommended to treat patients with idiopathic facial palsy with steroids. Steroids favour a complete recovery, decrease the risk of synkinesis, autonomic sequelae and contractures (...) proven. If eye closure remains incomplete as result of defective healing, one therapeutic option is lid loading of the upper eye lid. Moreover, in case of severe persistent palsy, several well-established microsurgical nerve and muscle plasty procedures are available.© Georg Thieme Verlag KG Stuttgart · New York.

2012 Laryngo- rhino- otologie

12. Bell's palsy

. Systematic reviews and meta-analyses Yang, W., Li, J., Ma, Q., et al. (2018) A Network Meta-Analysis to Compare the Efficacy of Steroid and Antiviral Medications for Facial Paralysis from Bell´s Palsy. Pain Physician. [ ] Primary evidence No new randomized controlled trials published in the major journals since 1 July 2018. New policies New policies No new national policies or guidelines since 1 July 2018. New safety alerts New safety alerts No new safety alerts since 1 July 2018. Changes in product (...) are not required in primary care for new-onset Bell's palsy. Basis for recommendation Basis for recommendation Bell's palsy as a diagnosis of exclusion The recommendation to diagnose Bell's palsy only if there is no other cause of facial weakness or paralysis is based on consensus expert opinion in a US clinical practice guideline on Bell's palsy from the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF). This advises using the history and examination to detect signs indicative

2012 NICE Clinical Knowledge Summaries

13. Bell Palsy (Follow-up)

parameter in 2001 stating that steroids are probably effective and acyclovir (with prednisone) is possibly effective for the treatment of Bell palsy. There was insufficient evidence for recommendations on facial decompression surgery. [ ] In 2012, the AAN released guidelines stating that steroids are highly likely to be effective and increase the likelihood of recovery of facial nerve function in new-onset Bell palsy [ , ] Guidelines from the American Academy of Otolaryngology—Head and Neck Surgery (...) mentioned, 2012 guidelines from the AAN state that steroids are highly likely to be effective and increase the likelihood of recovery of facial nerve function in new-onset Bell palsy [ , ] Guidelines from the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) were issued in November 2013 that also support the AAN guidelines. The guidelines recommend use of corticosteroids within 72 hours from the onset of symptoms. Antiviral agents (eg, acyclovir, valacyclovir) may

2014 eMedicine.com

14. Bell Palsy (Follow-up)

parameter in 2001 stating that steroids are probably effective and acyclovir (with prednisone) is possibly effective for the treatment of Bell palsy. There was insufficient evidence for recommendations on facial decompression surgery. [ ] In 2012, the AAN released guidelines stating that steroids are highly likely to be effective and increase the likelihood of recovery of facial nerve function in new-onset Bell palsy [ , ] Guidelines from the American Academy of Otolaryngology—Head and Neck Surgery (...) mentioned, 2012 guidelines from the AAN state that steroids are highly likely to be effective and increase the likelihood of recovery of facial nerve function in new-onset Bell palsy [ , ] Guidelines from the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) were issued in November 2013 that also support the AAN guidelines. The guidelines recommend use of corticosteroids within 72 hours from the onset of symptoms. Antiviral agents (eg, acyclovir, valacyclovir) may

2014 eMedicine.com

15. Bell Palsy (Diagnosis)

. This aberrant reconnection produces unusual neurologic pathways. When voluntary movements are initiated, they are accompanied by involuntary movements (eg, eye closure associated with lip pursing or mouth grimacing that occurs during blinking of the eye). The condition in which involuntary movements accompany voluntary movements is termed synkinesis. Previous References Baugh RF, Basura GJ, Ishii LE, Schwartz SR, Drumheller CM, Burkholder R, et al. Clinical Practice Guideline: Bell's Palsy Executive Summary (...) . Otolaryngol Head Neck Surg . 2013 Nov. 149(5):656-63. . Gronseth GS, Paduga R. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology . 2012 Nov 27. 79(22):2209-13. . Vrabec JT, Backous DD, Djalilian HR, Gidley PW, Leonetti JP, Marzo SJ, et al. Facial Nerve Grading System 2.0. Otolaryngol Head Neck Surg . 2009 Apr. 140(4):445-50. . Seiff SR, Chang J. Management of ophthalmic complications

2014 eMedicine.com

16. Bell Palsy (Diagnosis)

. This aberrant reconnection produces unusual neurologic pathways. When voluntary movements are initiated, they are accompanied by involuntary movements (eg, eye closure associated with lip pursing or mouth grimacing that occurs during blinking of the eye). The condition in which involuntary movements accompany voluntary movements is termed synkinesis. Previous References Baugh RF, Basura GJ, Ishii LE, Schwartz SR, Drumheller CM, Burkholder R, et al. Clinical Practice Guideline: Bell's Palsy Executive Summary (...) . Otolaryngol Head Neck Surg . 2013 Nov. 149(5):656-63. . Gronseth GS, Paduga R. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology . 2012 Nov 27. 79(22):2209-13. . Vrabec JT, Backous DD, Djalilian HR, Gidley PW, Leonetti JP, Marzo SJ, et al. Facial Nerve Grading System 2.0. Otolaryngol Head Neck Surg . 2009 Apr. 140(4):445-50. . Seiff SR, Chang J. Management of ophthalmic complications

2014 eMedicine.com

17. Bell Palsy (Treatment)

parameter in 2001 stating that steroids are probably effective and acyclovir (with prednisone) is possibly effective for the treatment of Bell palsy. There was insufficient evidence for recommendations on facial decompression surgery. [ ] In 2012, the AAN released guidelines stating that steroids are highly likely to be effective and increase the likelihood of recovery of facial nerve function in new-onset Bell palsy [ , ] Guidelines from the American Academy of Otolaryngology—Head and Neck Surgery (...) mentioned, 2012 guidelines from the AAN state that steroids are highly likely to be effective and increase the likelihood of recovery of facial nerve function in new-onset Bell palsy [ , ] Guidelines from the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) were issued in November 2013 that also support the AAN guidelines. The guidelines recommend use of corticosteroids within 72 hours from the onset of symptoms. Antiviral agents (eg, acyclovir, valacyclovir) may

2014 eMedicine.com

18. Bell Palsy (Treatment)

parameter in 2001 stating that steroids are probably effective and acyclovir (with prednisone) is possibly effective for the treatment of Bell palsy. There was insufficient evidence for recommendations on facial decompression surgery. [ ] In 2012, the AAN released guidelines stating that steroids are highly likely to be effective and increase the likelihood of recovery of facial nerve function in new-onset Bell palsy [ , ] Guidelines from the American Academy of Otolaryngology—Head and Neck Surgery (...) mentioned, 2012 guidelines from the AAN state that steroids are highly likely to be effective and increase the likelihood of recovery of facial nerve function in new-onset Bell palsy [ , ] Guidelines from the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) were issued in November 2013 that also support the AAN guidelines. The guidelines recommend use of corticosteroids within 72 hours from the onset of symptoms. Antiviral agents (eg, acyclovir, valacyclovir) may

2014 eMedicine.com

19. Bell Palsy (Overview)

. This aberrant reconnection produces unusual neurologic pathways. When voluntary movements are initiated, they are accompanied by involuntary movements (eg, eye closure associated with lip pursing or mouth grimacing that occurs during blinking of the eye). The condition in which involuntary movements accompany voluntary movements is termed synkinesis. Previous References Baugh RF, Basura GJ, Ishii LE, Schwartz SR, Drumheller CM, Burkholder R, et al. Clinical Practice Guideline: Bell's Palsy Executive Summary (...) . Otolaryngol Head Neck Surg . 2013 Nov. 149(5):656-63. . Gronseth GS, Paduga R. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology . 2012 Nov 27. 79(22):2209-13. . Vrabec JT, Backous DD, Djalilian HR, Gidley PW, Leonetti JP, Marzo SJ, et al. Facial Nerve Grading System 2.0. Otolaryngol Head Neck Surg . 2009 Apr. 140(4):445-50. . Seiff SR, Chang J. Management of ophthalmic complications

2014 eMedicine.com

20. Bell Palsy (Overview)

. This aberrant reconnection produces unusual neurologic pathways. When voluntary movements are initiated, they are accompanied by involuntary movements (eg, eye closure associated with lip pursing or mouth grimacing that occurs during blinking of the eye). The condition in which involuntary movements accompany voluntary movements is termed synkinesis. Previous References Baugh RF, Basura GJ, Ishii LE, Schwartz SR, Drumheller CM, Burkholder R, et al. Clinical Practice Guideline: Bell's Palsy Executive Summary (...) . Otolaryngol Head Neck Surg . 2013 Nov. 149(5):656-63. . Gronseth GS, Paduga R. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology . 2012 Nov 27. 79(22):2209-13. . Vrabec JT, Backous DD, Djalilian HR, Gidley PW, Leonetti JP, Marzo SJ, et al. Facial Nerve Grading System 2.0. Otolaryngol Head Neck Surg . 2009 Apr. 140(4):445-50. . Seiff SR, Chang J. Management of ophthalmic complications

2014 eMedicine.com

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