THE TERM Bell's palsy denotes facial paresis occurring suddenly in an otherwise healthy person. It is not due to trauma. It may be due to virus infection, as in the Ramsey-Hunt syndrome. (Patients with the Ramsey-Hunt syndrome are not considered in this report.) It may also be due to neighborhood focal infection, in which case its onset is more gradual, the treatment obvious, and the differentiation from the ischemic palsy clear.
The ischemic palsy is characterized by sudden onset with or without pain, usually the latter. Frequently, there is an exposure to cold, which is one mechanism of setting up an ischemia. This may explain why the percentage of severe cases with nonrecovery varies so much in different parts of the world. Neurosurgeons here see most of these patients, and they do not see such a high per cent of poor results with conservative treatment as is reported elsewhere. Perhaps
MARTIN RC. BELL'S PALSY. AMA Arch Otolaryngol. 1952;55(4):405–409. doi:10.1001/archotol.1952.00710010417001
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