ENT: Bell's Palsy: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Bell’s Palsy🎧 A clear, high-yield breakdown of this acute facial nerve palsy – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• Bell’s palsy is a sudden-onset, unilateral lower motor neuron (LMN) facial nerve (CN VII) paralysis• Often idiopathic, but linked to viral causes – notably HSV-1📌 Causes & Risk Factors• Likely viral (HSV-1, HZV, EBV, CMV)• Risk factors: pregnancy (3rd trimester), diabetes, recent viral illness, stress• Other causes: trauma, autoimmune (e.g. sarcoidosis), tumours, Lyme disease, Guillain-Barré🧠 Mnemonic: “BELLS”(Bugs – HSV, EBV, Lyme; Eclampsia; LMN lesion; Lyme; Sarcoidosis)📌 Pathophysiology• Inflammation of the facial nerve in the facial canal → swelling + compression• Disrupts motor, sensory & parasympathetic function (face, ear, taste, tear)📌 Symptoms• Unilateral facial weakness – sudden onset• Inability to close eye, drooping mouth, loss of forehead wrinkling• Altered taste (ant. 2/3 tongue), dry eye, hyperacusis🧠 Mnemonic: “FACE”(Facial droop, Altered taste, Can’t close eye, Ear pain/hyperacusis)📌 Differential Diagnosis• Stroke (UMN – forehead spared)• Ramsay Hunt syndrome (HZV + ear vesicles)• Lyme disease• Tumour or parotid pathology• GBS, sarcoidosis, MS📌 Diagnosis• Clinical diagnosis: LMN pattern, sudden onset• Look for: complete hemifacial weakness, inability to wrinkle forehead• Consider bloods (Lyme, viral titres) or imaging if atypical💡 Forehead clue:• Forehead spared = UMN (stroke)• Forehead involved = LMN (Bell’s)📌 Management• Eye care is criticalDay: artificial tearsNight: ointment + eye taping• Prednisolone – within 72 hours of onset• Antivirals: only in severe cases or if Ramsay Hunt suspected• Facial physiotherapy if persistent symptoms• Refer if: atypical, no recovery by 3 weeks, or complications (e.g., synkinesis)📌 Complications• Synkinesis (e.g., eye twitch when smiling)• Crocodile tears (gustatory lacrimation)• Persistent weakness, asymmetry• Dry eye complications, corneal ulcers• Psychological effects – depression, anxiety📌 Prognosis• Good prognosis – ~71% fully recover• 85% show improvement within 3 weeks• Poorer outcomes: complete paralysis at onset, age >60, diabetes, pregnancy, no early improvement• ~16% have lasting effects, ~5% have significant residual symptoms📎 More MSRA Resources for Bell’s Palsy📝 Revision Notes: https://www.passthemsra.com/topic/bells-palsy-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/bells-palsy-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/bells-palsy-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/bells-palsy-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/ent-for-the-msra/Hashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #BellsPalsy #ENT