Bell's Palsy

Description

General measures 

Medicine treatment 

Referral

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G51.0

DESCRIPTION

• Unilateral paralysis of all the muscles of facial expression (the corner of the mouth drops, the forehead is unfurrowed, and the eyelids will not close)
• Taste sensation may be lost unilaterally and hyperacusis (painful sensitivity to loud sounds) may be present
• Most patients recover within a few weeks or months

GENERAL MEASURES

• HIV testing
• Referral for facial muscle massage and exercises
• Eye pad for protection of the eye during sleep

MEDICINE TREATMENT

Adults

• Corticosteroids (intermediate-acting) e.g.:
  LoE:IVb⁴²
• Prednisone, oral, 60 mg daily for 7 days started within 72 hours, preferably within 48 hours of onset (Doctor prescribed)
  LoE:Ia⁴³

Children

• Corticosteroids (intermediate-acting) e.g.:
  LoE:IVb⁴⁴
• Prednisone, oral, 2 mg/kg daily for 7 days within 3 days of onset (Doctor prescribed)

Weight  (kg)	Dose (mg)	Tablet (5 mg)	Age  (Months/years)
>17.5–25 kg	40 mg	8 tablets	>5–7 years
>25–40 kg	55 mg	11 tablets	>7–12 years

REFERRAL

• If diagnosis uncertain
• All cases for physiotherapy, if available
• Eye irritation requiring lubrication

Click here to access the pdf.

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-4_Version 1.0_26 May 2025

Chapter 15: Central Nervous System Conditions_15.10 Neuropathy_15.10.2 Bell's Palsy