How is Bell's palsy diagnosed? Can it be done without hormone therapy?

Bell's palsy (idiopathic facial nerve palsy) is a peripheral facial paralysis caused by nonspecific inflammation of the facial nerve within the stylomastoid foramen

【Causes】

【Cause】【Cause】

The etiology of Bell's palsy is unknown, but may be related to the following factors:

①Viral infection : herpes virus, cytomegalovirus, mumps virus, rubella virus and HIV virus, etc.

① virus infection : ① virus infection : infection

②Cold stimulation: cold air stimulation, the nutrient microvascular spasm of the facial nerve, causing local tissue ischemia and hypoxia;

②Cold stimulation: ②Cold stimulation: blood vessels

③Immune abnormality: an autoimmune mechanism mediated by cellular immunity, Bell's palsy is more common in patients with a weakened immune system, such as those infected with human immunodeficiency virus

③Immune disorders : ③Immune disorders : Immunity

【Diagnostic Criteria】

【Diagnostic Criteria】Diagnosis

①Characteristics of disease course: acute onset, usually reaching a peak in about 3 days;

①Characteristics of course of disease: ①Characteristics of course of disease:

②Symptoms and signs: unilateral peripheral facial paralysis, with or without pain behind the ear, decreased taste in front of the tongue, hyperacusis, abnormal secretion of tears or saliva;

②Symptoms and signs: ②Symptoms and signs:

③Auxiliary examination: electromyography (unnecessary examination, suitable for severe cases to evaluate the degree of nerve damage and then judge prognosis) and head CT

③Auxiliary inspection: ③Auxiliary inspection:

【treat】

【Treatment】【Treatment】

The principle of treatment is to improve local blood circulation, reduce facial nerve edema, relieve nerve compression, promote nerve function recovery, avoid corneal complications and other sequelae, and inhibit virus replication

1.

1.

1.

Chinese guidelines for the diagnosis and treatment of idiopathic facial paralysis recommend that for all patients over 16 years old without contraindications, oral glucocorticoids should be used as soon as possible in the acute stage, and prednisone or prednisolone can be used orally, 30-60 mg/d, Continue to use for 5 days, and then gradually reduce the dose to stop within 5 days

Indigestion and gastric ulcer indigestion and gastric ulcer Digestion Calcium and potassium supplementation Calcium and potassium supplementation Hypokalemia and avascular necrosis of the femoral head Hypokalemia and avascular necrosis of the femoral head Ulcer, hypertension , kidney or liver disease, glaucoma, pregnancy, recent head trauma or mental illness Gastric or duodenal ulcer,high blood pressure , kidney or liver disease, glaucoma, pregnancy, recent head trauma or mental illnessBlood pressure 2.
Antiviral drugs 2.
Antiviral drugs Chinese guidelines recommend that for patients in the acute stage, antiviral drugs and glucocorticoids can be used in combination as soon as possible according to the situation.
Antiviral drugs and glucocorticoids are; however, antiviral drug therapy alone is not recommended .
However, monotherapy with antiviral drugs is not recommended.
Acyclovir or valaciclovir ,acycloviror valaciclovir 3.
Neurotrophic drugs 3.
Neurotrophic drugs₁₁₂ 2.
Eye protection II.
ointment eye drops or ointment eye patch 

   3.
Traditional Chinese Medicine Treatment 3.
Traditional Chinese Medicine Treatment 4.
Rehabilitation Exercise 4.
Rehabilitation Exercise Drug Treatment is the Main Principle of Individualized Treatment Principles of Individualized Treatment , , References: 1.
Neurology Branch of Chinese Medical Association, Chinese Medicine Neuromuscular Disease Group of Chinese Society of Neurology, Electromyography and Clinical Neurophysiology Group of Neurology Branch of Chinese Medical Association.
Guidelines for the diagnosis and treatment of idiopathic facial paralysis in China [J].
Chinese Journal of Neurology, 2016(2):84- 86.
2.
Ruan Guiji, Zhao Wenfeng, Lv Guangyao.
Issues related to the diagnosis and treatment of idiopathic facial nerve palsy with integrated traditional Chinese and Western medicine [J].
Chinese Journal of Clinicians, 2020, 48(4): 4.
Diagnosis and treatment 3.
Yu Fangping, Zhao Yingchun .
Advances in drug treatment of idiopathic facial paralysis[J].
Stroke and Neurological Diseases, 2021, 28(1):3.
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