Bell’s Palsy
Temporary paralysis of cranial nerve VII causing facial droop
Definition
Bell’s palsy is an acute, idiopathic peripheral paralysis of the facial nerve (cranial nerve VII) producing unilateral facial weakness or paralysis. Most cases resolve spontaneously within 3 to 6 months.
Signs and Symptoms
- Sudden unilateral facial droop (including forehead)
- Inability to close the eye on affected side
- Drooling, difficulty eating
- Altered taste anterior 2/3 of tongue
- Hyperacusis (sensitive hearing)
- Pain behind the ear
Key Differentiation From Stroke
Bell’s palsy affects the ENTIRE half of the face INCLUDING the forehead. Stroke typically spares the forehead because of bilateral cortical innervation of the upper face.
Treatment and Nursing Care
Corticosteroids (prednisone) within 72 hours; antivirals if HSV is suspected. Eye care is critical: artificial tears during the day, lubricant ointment and eye patch at night to prevent corneal abrasion. Oral care after meals. Provide soft diet and teach chewing on the unaffected side.
NCLEX Relevance
Key priority: protect the eye (corneal abrasion risk). Differentiate from CVA by forehead involvement.