Bell's Palsy & the House-Brackmann Score

Teaching Pearl: Bell's Palsy can be easily diagnosed by clinical examination, however the treatment varies depending on severity and the patient's own medical history. You should never prescribe steroids longer than antivirals, due to the possibility of a viral infection progressing while steroids are continued. Additionally, any patient who has a House-Brackmann score of IV or more, must go home with instructions and material to tape their eye shut at night, otherwise, they risk corneal abrasions and ulcers. You should also consider antivirals, and be sure to check their auditory canals for signs of herpetic skin lesions.