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Bell's Palsy Guidelines

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Figure 2. Bell's Palsy Management Algorithm Patient presenting with acute-onset, unilateral facial paresis/paralysis Assess patient with history & physical exam to exclude identifiable causes of facial paresis/paralysis YES Cause of facial paresis/paralysis identified? NO Offer oral antiviral therapy in addition to oral steroids Manage accordingly NO NO Prescribe oral steroids Does the patient have incomplete eye closure? Implement eye protection Does the patient have complete facial paresis/ paralysis? Does the patient have: 1. New or worsening neurologic findings at any point, or 2. Ocular symptoms developing at any point, or 3. Incomplete facial recovery 3 months after initial onset? YES Reassess or refer to a facial nerve specialist or ocular specialist for ocular symptoms Acute management of patient complete Optional Optional NO Diagnostic Treatment YES YES Offer electrodiagnostic testing

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