Bell's palsy

Sa？etak Bell's palsy (BP) is defined as a sudden, isolated and unilateral peripheral facial palsy caused by the facial nerve damage of an unknown origin and therefore called idiopathic. It was named after a Scottish surgeon, Sir Charles Bell, who published several papers on acute peripheral paresis of the facial nerve at the beginning of the 19th century. It is the most common acute mononeuropathy, with an annual incidence of 11-40 cases per 100,000 people. BP's etiology remains unclear, with the two main etiologic hypotheses – viral and autoimmune. The clinical picture usually develops within 72 hours and is manifested mainly by the weakness of mimic muscles, with associated symptoms such as retroauricular pain, hyperacusis, decreased tearing and altered taste. Diagnosis of BP is primarily based on history and clinical examination, and it is important to determine the severity of damage or the degree of nerve function using one of the available scoring systems. Since the cause of BP is unknown, the treatment is symptomatic. Because of that, it is extremely important to carefully carry out the diagnostics so as not to miss any known causes of facial nerve paresis and the earlier beginning of specific etiological treatment. The first three days after the onset of symptoms are essential to the beginning of treatment of BP, therefore good coordination of doctors of various specialties is necessary. The treatment of BP is multimodal and is based on glucocorticoid therapy, which has been shown to have a positive effect on improving the function of the facial nerve and reducing the duration of recovery, as well as the number of complications. Beside them, supportive measures such as eye protection and mime therapy are also essential to preserve muscle tone. The proper treatment of suitable patients can optimize the probability of nerve recovery. Although many BP patients will fully recover without treatment, in some of them permanent weakness of the mimic muscles may seriously impair their quality of life