Scenario: Bell's palsy Introduction Bell's palsy is an acute, unilateral, idiopathic, facial nerve paralysis. The paralysis also affects the eyelids, causing an impairment of blinking. It occurs most commonly between 15 and 60 years of age [DTB, 2006]. The cause remains unclear, but Bell's palsy has been associated with the herpes virus. What advice can I give people with Bell's palsy? Reassure the person that the prognosis is good: 85% of people with Bell's palsy make a full recovery within 9 months [Sullivan et al, 2007]. It is important to keep the affected eye lubricated. If the cornea is exposed after attempting to close the eyes, immediate referral to an ophthalmologist is required. Lubricating eye drops should be used during the day, and eye ointment used at night [DTB, 2006]. If the ability to close the eye at night is impaired, then people should be advised to tape the eye closed at bedtime using microporous tape Basis for recommendation The recommendations on eye-care are based on expert opinion [DTB, 2006]. The most significant clinical trial [Sullivan et al, 2007] followed up people after 3 months and 9 months. Most other systematic reviews and randomized controlled trials measured outcomes after 69 months. Supporting evidence: Evidence on the use of steroids There are two main benefits from prednisolone: faster recovery, and greater likelihood of complete recovery. A direct comparison of prednisolone versus no prednisolone [Sullivan et al, 2007] showed that ... Video Rating: 5 / 5
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