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October 1959

Bell's Palsy

Author Affiliations

Rochester, Minn.
Section of Otolaryngology and Rhinology, Mayo Clinic and Mayo Foundation. The Mayo Foundation, Rochester, Minn., is a part of the Graduate School of the University of Minnesota.

AMA Arch Otolaryngol. 1959;70(4):436-443. doi:10.1001/archotol.1959.00730040446004

The term "Bell's palsy" is commonly used to indicate the idiopathic type of facial paralysis. Of late, there seems to be general agreement that this disorder is the result of vasospasm of the nutrient vessels of the nerve with the usual effect of anoxia, that is, increased permeability of the vessel wall with consequent accumulation of interstitial fluid, thus, edema. Because the facial nerve is enclosed in a rigid bony canal the socalled tunnel syndrome is produced with its vicious circle of vasospasm, anoxia, edema, and pressure on vessels with further anoxia.

Audibert, Mattei, and Paganelli1 appear to have been the first to present this hypothesis. They considered that the only reasonable explanation of Bell's palsy is dysfunction of the autonomic nervous system, which produces spasm, thrombosis, or embolism in the vessels supplying blood to the facial nerve. They felt that the facial nerve is particularly susceptible to vasomotor