Clinical Case Database / Category: Clinical Care

Facial palsy

Publication details

Miss Gada Yassin MRCS (ENT) MBBS BSc DPMSA, Mr Alwyn R. D’Souza MBBS, FRCS (Oto), FRCS Ed, (ORL- HNS)
Foundation Years Journal, volume 7, issue 1, p.52 (123Doc Education, London, January 2013)


Facial palsy can commonly present at the GP surgery, ENT clinic or emergency department. The loss of muscle tone, symmetry, and dynamics compromises facial aesthetics, non-verbal communication and eating; it also risks damage to the eye; thus causing physical morbidity to the patient. Moreover, these can result in significant social and psychological morbidity. It is important to examine the facial nerve in head and neck patients as well as those with otological or neurological complaints. This article describes a case of facial nerve palsy. It explains how to assess a patient presenting with facial nerve palsy, the management and the relevant anatomy of the facial nerve.

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Miss Gada Yassin MRCS (ENT) MBBS BSc DPMSA

Surgery Education Fellow at Birmingham
Heartlands Hospital, Birmingham, United Kingdom

Mr Alwyn R. D’Souza MBBS, FRCS (Oto), FRCS Ed, (ORL- HNS)

ENT and Facial Plastics Consultant at University
Hospital Lewisham, London, United Kingdom


1. Royal College of Optometrists clinical management guidelines. Facial Palsy (including Bell’s Palsy). cfm/docid/63AD5CC8-EB0F-41CB-89508DC2D43560FB
2. El-Hawrani AS, Eng CY, Ahmed SK et al. General practitioner’s referral pattern for children with acute facial paralysis. J Laryngol Otol, 2005, 119(7): 540-542
3. de Almeida JR, Al Khabori M, Guyatt GH et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis. JAMA 2009, 302:985.
4. Quant EC, Jeste SS, Muni RH, et al. The benefits of steroids versus steroids plus antivirals for treatment of Bell’s palsy: a meta-analysis. BMJ 2009, 339:b3354.
5. Sullivan FM, Swan IR, Donnan PT, et al. Early treatment with prednisolone or acyclovir in Bell’s palsy. N Engl J Med 2007, 357:1598.
6. Engström M, Berg T, Stjernquist-Desatnik A, et al. Prednisolone and valaciclovir in Bell’s palsy: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet Neurol 2008, 7:993.
7. Corbridge R and Steventon N. Oxford handbook of ENT and head and neck surgery, 1st edition, New York: Oxford University Press, 2006, p.422
8. Ramakrishnan Y, Alam S, Kotecha A, et al. Reanimation following facial palsy: present and future directions. J Laryngol Otol, 2010, 124(11):1146-1152
9. House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg, 1985, 93(2):146-7.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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