Clinical Case Database / Category: Patient Management

Facial nerve palsy

Publication details

Kim To MBBS, BSc (Hons), Aanand Acharya MA, FRCS (ORL-HNS)
Foundation Years Journal, volume 7, issue 4, p.20 (123Doc Education, London, April 2013)


This case based discussion focuses around the presentation of a pregnant lady to the A&E department with sudden onset left-sided facial paralysis. The key aspects of the foundation curriculum that will be covered include good clinical care (eliciting a history, examination, diagnosis, clinical decision making, safe prescribing); maintaining good medical practice (lifelong learning, evidencebased guidelines); relationship with patients and communication skills; and working with colleagues (communication with colleagues, teamwork for patient safety, interface with different specialties).

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Kim To MBBS, BSc (Hons)

FY2 in A&E
Good Hope Hospital
Rectory Road
Sutton Coldfield
B75 7RR

Aanand Acharya MA, FRCS (ORL-HNS)

Specialist Registrar in ENT
Birmingham Children’s Hospital
Steelhouse Lane
B4 6NH


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3. Tiemstra JD, Khatkhate N. Bell’s Palsy: Diagnosis and Management. Am Fam Physician 2007; 76:997-1002.
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5. Pitts DB, Adour KK, Hilsinger RL Jr. Recurrent Bell’s Palsy: analysis of 140 patients. Laryngoscope 1988;98:535-40.
6. Rahman I, Sadiq SA. Ophthalmic Management of Facial Nerve Palsy: A Review. Surv Ophthalmol 2007; 52:121-44.
7. Wagner G, Klinge H, Sachse MM. Ramsay Hunt Syndrome. J Dtsch Dermatol Ges 2012; 10: 238-44.
8. Volpi A. Severe complications of herpes zoster. Herpes 2007; 14: suppl 2(35-9).
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10. Veillon F, Taboada LR, Eid MA et al. Pathology of the facial nerve. Neuroimaging Clin N Am. 2008; 18:309-320.
11. Standard Computerised Revalidation Instrument for Prescribing and Therapeutics (SCRIPT). Prescribing in pregnancy. Last accessed July 2012.
12. Murakami S, Mizobuchi M, Nakashiro Y et al., Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle. Ann Intern Med 1996; 124:27-30.
13. Salinas RA, Alvarez G, Daly F, Ferreira J. Corticosteroids for Bell’s palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2010; 17:CD001942.
14. Sullivan FM, Swan IR, Donnan PT et al., Early treatment with Prednisolone
or acyclovir in Bell’s palsy. NEJM 2007; 18:1598-607.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.