Clinico Etiological Profile of Patients with Acute Lower Motor Neuron Facial Palsy and Treatment Outcome of Bell’s Palsy: A Prospective Study in a Tertiary Care Centre

Introduction: Acute lower motor neuron (LMN) facial palsy is a debilitating condition with diverse etiologies. Bell’s palsy stands as the single most common cause, distinguishing it from other secondary aetiologies viz trauma, infection etc. Methods: This was a prospective observational study conducted in the Department of otorhinolaryngology at a tertiary care teaching government medical college, Thrissur. A total of fifty patients who presented with symptoms of acute LMN facial palsy were evaluated. Detailed examination of the Clinical features, comorbidities, and the radiological findings were evaluated. Patients who were diagnosed to have Bell’s palsy were treated with corticosteroids/antivirals and they were followed up for a period of 12 weeks using validated House–Brackmann (HB) grading system. Results: The mean age of the study cohort was 48.0 ± 13.9 years. Bell’s palsy was found to be the predominant etiology (62%), which was followed by temporal bone fracture (18%) and then chronic otitis media (10%). Otalgia was observed as a significant associated symptom (46%). Among the diagnosed Bell’s palsy patients (n=31), two thirds (67.7%) achieved good recovery (HB Grade I–II) at the end of 12 weeks. Conclusion: A high index of suspicion about secondary causes is necessary in tertiary settings, wherein trauma and otological disease constitutes a considerable portion of facial palsy cases. Early Medical intervention yields a favourable functional outcome among idiopathic cases.