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Bell’s Palsy: That Was Then, This Is Now

Mel Herbert, MD MBBS FAAEM, Joe Lex, MD, Stuart Swadron, MD, FRCPC, and Billy Mallon, MD FAAEM
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17:27
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Nurses Edition Commentary

Mel Herbert, MD MBBS FAAEM, Kathy Garvin, RN, and Lisa Chavez, RN
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01:56

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EM:RAP 2015 November Summary 665 KB - PDF

What has changed in the treatment of Bell’s palsy in the last decade - we go down memory lane to find out!

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Amy O. -

Thanks for the refresher on Bells. This piece reminded me of a case I had when I was practicing in a small town in New Zealand. I was pretty green and had a middle aged guy come in with a raging headache, hypertension (SBP in the 180s if I remember correctly), and unilateral facial drooping WITH forehead sparing. I was convinced this guy was having a CVA but would have to transfer him for a CT. Closest hospital was 2 hours by ground ambulance (no neurosurg there) OR 45 minutes by helicopter to Christchurch. I was so worried that the guy could have a bleed that I elected to transfer him via chopper to a hospital with neurosurg. Long story short (you know where I'm going with this), I was later told that it was just a Bell's palsy. I still think I did the right thing for the patient with the info that I had available, but it's a good thing this was in NZ where the patient's bills wouldn't be off the charts!

Kevin M., MD -

Had a patient recently with bilateral Bell's. Ruled out the usual suspects. Turns out that the cause was sarcoidosis.

amy b., DO -

Can't the patient also have involvement of upper face (forehead) if the lesion is in the brainstem ?

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Codes and Cath Labs Full episode audio for MD edition 231:38 min - 323 MB - M4AEM:RAP 2015 November Aussie Edition Australian 26:35 min - 36 MB - MP3EM:RAP 2015 November Canadian Edition Canadian 16:25 min - 23 MB - MP3EM:RAP 2015 Español Noviembre 2015 Español 72:56 min - 38 MB - MP3EM:RAP 2015 Novembre Résumé en Francais Français 53:50 min - 32 MB - MP3EM:RAP 2015 Español Noviembre 2015 1 MB - PDFEM:RAP 2015 November Board Review Answers 263 KB - PDFEM:RAP 2015 November Board Review Questions 232 KB - PDFEM:RAP 2015 November MP3 279 MB - ZIPEM:RAP 2015 November Summary 665 KB - PDF

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