Fast Five Quiz: How Much Do You Know About Bell Palsy?

Bell palsy, or idiopathic facial paralysis, is the most common peripheral paralysis of the facial nerve (cranial nerve VII). Many cases of facial nerve paralysis have identifiable etiologies, such as stroke, Lyme disease, or Ramsay Hunt syndrome, but Bell palsy is, by definition, idiopathic in nature.
How much do you know about Bell palsy and its management? Check your knowledge with this quick quiz.
Type 2 diabetes is associated with several types of peripheral neuropathy, including Bell palsy. The prevalence of peripheral neuropathy among patients with type 2 diabetes has been calculated to be as high as 53.6%. In one retrospective cohort study, 33% of participants with Bell palsy had coexisting type 2 diabetes. Additionally, obesity might increase the risk for Bell palsy.
Some studies have concluded that there is a slight female preponderance among patients with Bell palsy, whereas others have found no sex predilection. Even if female sex is not a risk factor, evidence suggests that Bell palsy is associated with pregnancy.
The median age of onset is 40 years, and patient age < 15 years is not a risk factor. However, Bell palsy has been identified in children and even infants.
Facial nerve trauma can certainly cause symptoms resembling Bell palsy, but Bell palsy is idiopathic and does not have a traumatic etiology. If these symptoms resulted from trauma, the diagnosis would be traumatic facial nerve palsy rather than Bell palsy.
Learn more about Bell palsy epidemiology.
Lagophthalmos, but not true eyelid ptosis, is a characteristic feature of Bell palsy.
Symptoms of Bell palsy typically have a rapid onset, manifesting from 24 to 72 hours and often resolving or partially resolving within a few weeks to 3 months. In Bell palsy, facial paralysis is usually unilateral, and bilateral facial paralysis should lead to consideration and evaluation for other etiologies. Hearing loss is not a typical symptom of Bell palsy. The presence of hearing loss indicates an association with an upper motor neuron lesion or a lesion involving more than the facial nerve.
Learn more about Bell palsy presentation.
A rapid evidence review on Bell palsy points out that, as the condition is idiopathic, laboratory diagnostics are not required for a diagnosis. Clinical practice guidelines from the American Academy of Otolaryngology-Head and Neck Surgery concur that diagnostic testing is not needed to identify Bell palsy. The guidelines recommend that clinicians should not obtain routine laboratory testing in patients with new-onset Bell palsy, pointing out that this approach is not cost-effective. However, both the rapid evidence review and guidelines state that laboratory testing can help identify systemic causes of facial palsy symptoms, such as Lyme disease or diabetes, when reasonable clinical suspicion exists.
Learn more about workup for Bell palsy.
Oral corticosteroids are recommended in a rapid evidence review as the first-line treatment for Bell palsy. Guidelines from the American Academy of Otolaryngology-Head and Neck Surgery also recommend this approach in patients age = 16 years with Bell palsy.
Antiviral monotherapy has not been demonstrated to influence recovery and should be avoided. However, combination therapy with oral corticosteroids and antivirals should be considered, as this approach consistently results in lower rates of synkinesis and might reduce rates of incomplete recovery.
Local injectable anesthetic would not be an appropriate therapy because it would not address the underlying cause, lower motor neuron palsy. There is no evidence-based role for local anesthetic in the treatment of Bell palsy.
Electroconvulsive therapy is mostly used in the treatment of severe mood disorders. The mechanism of action would not be expected to be useful in the treatment of facial nerve palsy.
Learn more about management of Bell palsy.
Along with the Sunnybrook facial grading system, the House-Brackmann scale is widely used to qualify symptom severity of Bell palsy. A patient with obvious facial weakness, inability to move the forehead, incomplete closure of the eyelids, and mouth asymmetry with maximal effort would be grade IV, moderately severe symptoms.
Grade I is classified as a normal presentation with full facial function in all areas. Grade II is characterized by slight facial weakness on close inspection, slight synkinesis, and no lagophthalmos. Grade III would exhibit moderate symptoms with noticeable, but not severe, synkinesis; obvious facial asymmetry but not disfiguring; complete eyelid closure with effort; and slightly weak mouth even with maximal effort.
Learn more about Bell palsy prognosis.

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It is specifically designed for once-weekly subcutaneous administration, and with its low peak-to-trough ratio, it has the potential to provide more stable glucose levels (less glucose variability) throughout the week. About Lilly Lilly is a medicine company turning science into healing to make life better for people around the world. We've been pioneering life-changing discoveries for nearly 150 years, and today our medicines help tens of millions of people across the globe. Harnessing the power of biotechnology, chemistry and genetic medicine, our scientists are urgently advancing new discoveries to solve some of the world's most significant health challenges: redefining diabetes care; treating obesity and curtailing its most devastating long-term effects; advancing the fight against Alzheimer's disease; providing solutions to some of the most debilitating immune system disorders; and transforming the most difficult-to-treat cancers into manageable diseases. With each step toward a healthier world, we're motivated by one thing: making life better for millions more people. That includes delivering innovative clinical trials that reflect the diversity of our world and working to ensure our medicines are accessible and affordable. To learn more, visit and or follow us on Facebook, Instagram, and LinkedIn. P-LLY The efficacy estimand represents the treatment effect on all participants who adhered to the study drug without initiating rescue therapy for persistent severe hyperglycemia. From a baseline of 8.20% for efsitora and 8.28% for insulin glargine. Participants treated with efsitora received a starting dose of 100 units of insulin, followed by escalation to fixed dosages of 150 units, 250 units and 400 units every four weeks, as needed, until achieving a target fasting blood glucose of 80-130 mg/dL. Participants with fasting blood glucose greater than 130 mg/dL on or after 16 weeks were transferred to flexible dosing. From a baseline of 7.80% for both efsitora and insulin degludec. From a baseline of 8.18% for both efsitora and insulin glargine. The treatment-regimen estimand represents the estimated average treatment effect regardless of treatment discontinuation or introduction of rescue therapy for persistent severe hyperglycemia. Blood glucose <54 mg/dL. Nocturnal hypoglycemia was defined as any event that occurred at night between midnight and 6 a.m. Cautionary Statement Regarding Forward-Looking StatementsThis press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about insulin efsitora alfa as a potential treatment for people with type 2 diabetes and the timeline for future readouts, presentations, and other milestones relating to insulin efsitora alfa and its clinical trials and reflects Lilly's current beliefs and expectations. However, as with any pharmaceutical product, there are substantial risks and uncertainties in the process of drug research, development, and commercialization. Among other things, there is no guarantee that future study results will be consistent with study results to date, that insulin efsitora alfa will prove to be a safe and effective treatment for type 2 diabetes, that insulin efsitora alfa will receive regulatory approval, or that Lilly will execute its strategy as expected. For further discussion of these and other risks and uncertainties that could cause actual results to differ from Lilly's expectations, see Lilly's Form 10-K and Form 10-Q filings with the United States Securities and Exchange Commission. Except as required by law, Lilly undertakes no duty to update forward-looking statements to reflect events after the date of this release. Trademarks and Trade NamesAll trademarks or trade names referred to in this press release are the property of the company, or, to the extent trademarks or trade names belonging to other companies are referenced in this press release, the property of their respective owners. Solely for convenience, the trademarks and trade names in this press release are referred to without the ® and ™ symbols, but such references should not be construed as any indicator that the company or, to the extent applicable, their respective owners will not assert, to the fullest extent under applicable law, the company's or their rights thereto. We do not intend the use or display of other companies' trademarks and trade names to imply a relationship with, or endorsement or sponsorship of us by, any other companies. Refer to: Niki Biro; niki_biro@ 317-358-9074 (Media)Michael Czapar; czapar_michael_c@ 317-617-0983 (Investors) View original content to download multimedia: SOURCE Eli Lilly and Company Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data

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