What is the typical sequence of symptoms in Bell palsy?

What is the typical sequence of symptoms in Bell palsy?

• A. Sudden unilateral facial weakness followed by ear pain
• B. Sudden ear pain followed by unilateral facial weakness
• C. Bilateral facial weakness with a rash
• D. Gradual onset facial weakness

Answer: (B)

Bell palsy is an acute peripheral facial nerve palsy, and the ear area often becomes painful before the facial weakness appears. Inflammation of the facial nerve as it travels through the facial canal can cause ear or mastoid-area pain, and this pain typically precedes the sudden unilateral weakness that follows over hours. The weakness then manifests as drooping of one side of the face and difficulty closing the eye or smiling on that side. If you see facial paralysis with a vesicular rash on the ear, think Ramsay Hunt syndrome rather than Bell palsy. Gradual onset or bilateral weakness points away from Bell palsy and toward other causes. So the typical sequence is sudden ear pain followed by unilateral facial weakness.

Bell palsy is an acute peripheral facial nerve palsy, and the ear area often becomes painful before the facial weakness appears. Inflammation of the facial nerve as it travels through the facial canal can cause ear or mastoid-area pain, and this pain typically precedes the sudden unilateral weakness that follows over hours. The weakness then manifests as drooping of one side of the face and difficulty closing the eye or smiling on that side. If you see facial paralysis with a vesicular rash on the ear, think Ramsay Hunt syndrome rather than Bell palsy. Gradual onset or bilateral weakness points away from Bell palsy and toward other causes. So the typical sequence is sudden ear pain followed by unilateral facial weakness.