Widened palpebral fissure has been regarded as one of the hallmarks of Bell's palsy. However, the palpebral fissure on the affected side may be narrower than that of the unaffected side. The narrowing of the palpebral fissure has been often thought as a sign caused by weakness of the levator palpebrae and Muller's muscles. However, weakness of the frontal muscle may cause drooping of the eyebrow, resulting in the narrowing of the palpebral fissure. We describe a patient of Bell's palsy with a narrowing of the palpebral fissure.
Bell Palsy* ; Eyebrows ; Humans ; Muscles

No abstract available.
Bell Palsy ; Decompression ; Facial Nerve

OBJECTIVES: We have analyzed the correlation between the House-Brackmann (HB) scale and Facial Nerve Grading System 2.0 (FNGS 2.0) in patients with Bell palsy, and evaluated the usefulness of the new grading system. METHODS: Sixty patients diagnosed with Bell palsy from May 2009 to December 2010 were evaluated using the HB scale and FNGS 2.0 scale during their initial visit, and after 3 and 6 weeks and 3 months. RESULTS: The overall intraclass correlation coefficient (ICC) was 0.908 (P=0.000) and the Spearman correlation coefficient (SCC) was 0.912 (P<0.05). ICC and SCC displayed differences over time, being 0.604 and 0.626, respectively, at first visit; 0.834 and 0.843, respectively, after 3 weeks; 0.844 and 0.848, respectively, after 6 weeks; and 0.808 and 0.793, respectively, after 3 months. There was a significant difference in full recovery, depending on the scale used (HB, P=0.000; FNGS 2.0, P<0.05). The exact agreements between regional assessment and FNGS 2.0 for the mouth, eyes, and brow were 72%, 63%, and 52%, respectively. CONCLUSION: FNGS 2.0 shows moderate agreement with HB grading. Regional assessment, rather than HB grading, yields stricter evaluation, resulting in better prognosis and determination of grade.
Bell Palsy ; Eye ; Facial Nerve ; Humans ; Mouth ; Prognosis

Bell's palsy is the most common cause of unilateral, lower motor facial palsy. Especially recurrent paralysis of the facial nerve is an unusual occurrence and reported in only 7-8%. We report a case of recurrent bilateral Bell's palsy who suffered from acute pancreatitis. Numerous complications can occur after acute pancreatitis, but recurrent bilateral Bell's palsy was not reported yet.
Bell Palsy ; Facial Nerve ; Facial Paralysis ; Pancreatitis ; Paralysis

Ranunculus tachiorei is a member of the buttercup family (Ranunculaceae) which contains unsaturated lactone and protoanemonine. Protoanemonine is formed by the breakdown of the glycoside Ranunculin after injury to the plant and causes severe vesiculation and linear streaks after contact with field buttercups(Ranunculus spp.) The amount of protoanemonine in buttercups varies widely with the species of plant and its stage of growth, the highest content being at the time of flowering. We report a case of primary irritant dermatitis due to contact with Ranunculus Tachiorei which was applied for the folk treatment of Bell palsy.
Bell Palsy ; Dermatitis, Irritant* ; Flowers ; Humans ; Plants ; Ranunculus*

Bilateral facial palsy is uncommon and it accounts for 0.3-2.0% of the facial palsy cases. In contrast to unilateral facial palsy, bilateral facial palsy may occur in association with a variety of neurological, infectious, neoplastic, traumatic, metabolic or degenerative disorders. Diabetes has been associated with bilateral facial palsy. Diabetes is more common among patients with bilateral facial palsy. But the correlation between diabetics and bilateral facial palsy is unclear. Herein, we report a case of a 66 year-old woman with bilateral Bell's palsy associated with uncontrolled diabetes mellitus.
Bell Palsy ; Diabetes Mellitus ; Facial Paralysis ; Female ; Humans

Central serous chorioretinopathy (CSCR) is potential ophthalmologic sequelae of steroid use characterized by an idiopathic serous detachment of neurosensory retina within the macula. Its etiology and pathophysiology are still unknown, but what has been implicated to cause CSCR is the the use of corticosteroid via multiple administration routes including oral, intravenous, inhaled, intranasal, epidural and intraarticular as well as topical forms. We report, with a review of the literature, an additional case of CSCR, which developed during systemic corticosteroid treatment in a Bell's palsy patient.
Bell Palsy ; Central Serous Chorioretinopathy ; Humans ; Retina ; Steroids

Bilateral simultaneous Bell's palsy is extremely rare and occurs in about 0.3-2.0% of the facial palsy cases. In contrast to the unilateral form of facial palsy, which often has an unknown cause, bilateral facial palsy is increasingly recognized as secondary to a variety of other disorders, including neurological, infectious, traumatic, metabolic, vascular, neoplastic, and degenerative disorders. Yet, bilateral simultaneous Bell's palsy is by definition, not associated with any demonstrable disease along the course of the facial nerve or elsewhere in the body. So, as usual, it is important to make an early diagnosis for the best treatment. We report our experience with two cases of bilateral simultaneous Bell's palsy recently seen in our practice.
Bell Palsy ; Early Diagnosis ; Facial Nerve ; Facial Paralysis

OBJECTIVE: To investigate the correlation between the severity of paralysis and hand sympathetic skin response (SSR) in patients with Bell's palsy and to evaluate the clinical utility of hand SSR as a predicting factor of prognosis. METHOD: Twenty patients with Bell's palsy and twenty normal controls were recruited. The severity of paralysis was graded according to House-Brackmann Facial Grading Scale (H-B FGS), and percent degeneration of Nasalis was determined by Facial Nerve Conduction Study (FNCS). RESULTS: The difference of hand SSR amplitude between affected and unaffected side was significant (p<0.05). There was significant correlation between H-B FGS and the difference of hand SSR amplitude (p<0.05). There was significant correlation between percent degeneration and the difference of hand SSR amplitude (p<0.05). There were significant correlations between the difference of hand SSR amplitude at 5 days and percent degeneration at 9 and 14 days (p=0.026, p=0.001). CONCLUSION: The difference of hand SSR amplitude between affected and unaffected side was useful for the indication of the severity of paralysis. And, hand SSR would be useful for an early prognostic predictor in Bell's palsy.
Bell Palsy* ; Facial Nerve ; Hand* ; Humans ; Paralysis ; Prognosis ; Skin*

OBJECTIVE: To investigate the diagnostic significance of transcranial magnetic stimulation (TMS) compared with electroneurography (ENoG) in very early period of Bell's palsy. METHOD: Thirty-six Bell's palsy patients within four days of disease onset were recruited and disease severity was assessed using the House-Brackmann grading system on the first visit, on the second visit (14 days later) and one year later. TMS at the labyrinthine segment was performed only on the first visit, while ENoG was done on the first and second visit. RESULTS: The amplitude ratio of magnetically evoked muscle responses between the affected side and the healthy side was correlated significantly with the clinical course and the final outcome which were documented using the House-Brackmann grade, whereas ENoG was not on the first visit. On the other hand, ENoG on the second visit was correlated significantly with the final outcome. CONCLUSION: In the early period of Bell's palsy, magnetically evoked muscle responses by TMS reflect neural insult more accurately than ENoG. TMS could be a useful measuring tool for the diagnosis and prognosis of Bell's palsy in the acute stage.
Bell Palsy ; Hand ; Humans ; Magnets ; Muscles ; Prognosis ; Transcranial Magnetic Stimulation