MRCP revision battle 42.1: Bell's palsy
MRCP revision battle 42.2: Mononeuropathies
MRCP revision battle 42.3: Carpal tunnel syndrome
MRCP revision battle 42.4: Diabetic neuropathy
MRCP revision battle 42.5: Nystagmus
MRCP revision battle 42.6: Miosis
MRCP revision battle 42.7: Picks Disease
MRCP revision battle 42.1: Bell's palsy
Bell's palsy is an acute, unilateral, idiopathic facial nerve paralysis.
It affects LMN.
Classical features are:
- sudden onset unilateral facial weakness
- numbness/pain behind ipsilateral ear
- absent taste from anterior 2/3rds of tongue
- dry eyes
- hypersensitivity to sound
Treatment is prednisolone for 10 days.
Some evidence suggests giving aciclovir as varicella zoster antibodies are often raised.
The eye should be protected - artificial tears, taping of eye at night, ?tarsorrhaphy.
Most cases fully recover; 15% will have a prolonged or incomplete recovery.
Some subsquently suffer from 'crocodile tears' = eating stimulates unilateral lacrimination instead of salivation.
Now on to some more mononeuropathies...
