Cause Of Facial Palsy Research Articles

Diagnosis and management of suspected Lyme neuroborreliosis-related facial nerve palsy in children by paediatricians and general practitioners: a French survey.

Most participants were uncomfortable with the diagnosis of LNB. There was a limited difference in the management of LNB in children between GPs and paediatricians. • Lyme neuroborreliosis (LNB) is the second cause of facial nerve palsy in Europe, and its diagnosis is based on neurological symptoms and a lumbar puncture. However, no clinical criteria could be used to differentiate Bell's palsy and LNB. Moreover, data on the adjunctive corticosteroid treatment and outcome in patients with LNB-related facial nerve palsy are controversial. • Most participants were uncomfortable with the diagnosis of LNB. Its management was heterogeneous and most often not consistent with guidelines. Only 28% of participants requested a lumbar puncture in cases of suspected LNB, and 17% prescribed antibiotics with corticosteroids. • This study highlights the need for new specific guidelines in management (need for lumbar puncture and/or LB serology) and treatment (time to antibiotic initiation, probabilistic therapy, role of corticosteroids, doxycycline in children younger than 8years) of LNB in children.

Rethinking Oncologic Facial Nerve Reconstruction in the Acute Phase Through Classification of the Level of Injury.

Early facial nerve reconstruction should be offered in every patient with oncological resections of the facial nerve due to the debilitating functional and psychosocial consequences of facial nerve palsy. Oncologic pathology or oncologic resection accounts for the second most common cause of facial nerve palsy. In the case of these acute injuries, selecting an adequate method for reconstruction to optimize functional and psychosocial well-being is paramount. Authors advocate consideration of the level of injury as a framework for approaching the viable options of reconstruction systematically. Authors breakdown oncologic injuries to the facial nerve in three levels in relation to their nerve reconstruction methods and strategies: Level I (intracranial to intratemporal), Level II (intratemporal to extratemporal and intraparotid), and Level III (extratemporal and extraparotid). Clinical features, common clinical scenarios, donor nerves available, recipient nerve, and reconstruction priorities will be present at each level. Additionally, examples of clinical cases will be shared to illustrate the utility of framing acute facial nerve injuries within injury levels. Selecting donor nerves is critical in successful facial nerve reconstruction in oncological patients. Usually, a combination of facial and nonfacial donor nerves (hybrid) is necessary to achieve maximal reinnervation of the mimetic muscles. Our proposed classification of three levels of facial nerve injuries provides a selection guide, which prioritizes methods for function nerve reconstruction in relation of the injury level in oncologic patients while prioritizing functional outcomes.

Clinical characteristics and prognosis of two anastomosis techniques in the treatment of facial nerve defects

Objective:To investigate the characteristics and prognosis of two anastomosis techniques in repairing facial nerve defects. Methods:A retrospective analysis was conducted on 30 patients who underwent facial nerve anastomosis（direct or rerouting） for facial nerve defects in our department from January 2012 to December 2021. Among them, 21 were male and 9 were female, with an average age of（37.53±11.33） years, all with unilateral onset. Preoperative House-Brackmann（H-B） facial nerve function grades were Ⅳ in 2 cases, Ⅴ in 9 cases, and Ⅵin 19 cases. The duration of facial paralysis before surgery was within 6 months in 21 cases, 6-12 months in 6 cases, and over 1 year in 3 cases. The causes of facial paralysis included 14 cases of cholesteatoma, 6 cases of facial neurioma, 6 cases of trauma, and 4 cases of middle ear surgery injury. Surgical approaches included 9 cases of the middle cranial fossa approach, 8 cases of labyrinthine-otic approach, 7 cases of mastoid-epitympanum approach, and 6 cases of retroauricular lateral neck approach. Results:All patients were followed up for more than 2 years. The direct anastomosis was performed in 10 cases: 6 cases with defects located in the extratemporal segment and 4 cases in the tympanic segment. Rerouting anastomosis was performed in 20 cases: 11 cases with defects located in the labyrinthine-geniculate ganglion, 4 cases from the internal auditory canal to the geniculate ganglion, 3 cases in the internal auditory canal, and 2 cases in the horizontal-pyramid segment. Postoperative H-B facial nerve grades were Ⅱ in 2 cases, Ⅲ in 20 cases, and Ⅳ in 8 cases, with 73.3%（22/30） of patients achieving H-B grade Ⅲ or better. Conclusion:Both direct and rerouting anastomosis techniques can effectively repair facial nerve defects, with no significant difference in efficacy between the two techniques. Most patients can achieve H-B grade Ⅲ or better facial nerve function recovery. Preoperative facial nerve function and duration of facial paralysis are the main prognostic factors affecting the outcome of facial nerve anastomosis.

Effects of acupuncture for Bell's palsy patients in the acute phase and its impact on facial nerve edema: a study protocol for a randomized, controlled trial.

Bell's palsy is an acute peripheral facial neuropathy, which is one of the most common causes of facial palsy of lower motor neurons. Facial nerve swelling is commonly observed in Bell's palsy. Acupuncture therapy has been widely used in the treatment of Bell's palsy. However, whether acupuncture can be effectively used in the acute stage is still controversial. There are no clinical trials conducted previously to evaluate the effect of acupuncture on facial nerve edema in Bell's palsy patients. The study aims to evaluate the potential efficacy of different acupuncture modalities on Bell's palsy patients in the acute phase, its effect on facial nerve edema, and to preliminarily explore its possible mechanism. In this randomized, controlled trial, 165 Bell's palsy patients with unilateral onset within 3 days will be recruited and randomly assigned to either the electroacupuncture group (n = 33), the acupuncture group (n = 33), the sham acupuncture group (n = 33), the blank control group (n = 33), or the acupuncture control group (n = 33) in a 1:1:1:1:1 ratio. The participants will receive 4 weeks of treatment and 8 weeks of follow-up. The five groups of participants will receive the following treatments: A: Electroacupuncture + Medication (prednisone acetate tablets, mecobalamin tablets, and vitamin B1 tablets); B: Acupuncture + Medication; C: Sham Acupuncture + Medication; D: Medication only; and E: Acupuncture only. The primary outcome will be the effectiveness rate of different acupuncture modalities in improving facial nerve function after the intervention period. The secondary outcomes will be the recovery speed, the diameter of the facial nerve, the echo intensity and thickness of facial muscles, blood flow parameters of the facial artery, the serum inflammatory level, safety evaluation, and adverse events. Preliminary exploration of its mechanism of action occurs through inflammation and immune response. The difference between groups will be assessed using repeated measure analysis of covariance (ANCOVA) and trend chi-square. The trial will evaluate the efficacy and facial nerve edema of acupuncture for Bell's palsy patients in the acute phase and preliminarily explore its possible mechanism. The results thus may provide evidence for clinical application. https://www.chictr.org.cn/bin/project/edit?pid=133211, identifier ChiCTR2100050815.

Parálisis facial, la importancia de realizar una buena historia clínica

Facial palsy poses a wide differential diagnosis in pediatrics, especially when it is accompanied by symptoms that make it doubtful whether Bell's palsy is present. It is essential to perform a correct anamnesis to rule out diagnoses that require early detection and treatment to improve the prognosis. Lyme disease (EL) is one of the possible causes of facial palsy, having been seldom described in children in Spain. We present the case of an 11-years-old male with diagnosis of facial palsy associated with B. burgdorferi infection with favorable evolution after treatment with doxycycline.

Facial Nerve Paralysis After Dental Extraction

Parotitis is inflammation of the parotid gland caused by infection, either virus or bacteria. Facial nerve palsy with an associated parotid mass should always be investigated for underlying neoplasm. Facial nerve palsy is an unusual symptom of inflammation of the parotid gland. We report two cases of unilateral facial paralysis associated with acute parotitis. The patients experience ipsilateral facial paralysis, accompanied by additional symptoms that varied between cases. Infective causes of facial nerve palsy usually have good prognosis. Keywords: Parotid gland, Facial nerve, Facial paralysis; Parotitis, Neoplasm

Facial nerve palsy in a neonate secondary to acute otitis media

Neonatal septicemia continues to be a significant cause of neonatal morbidity and mortality. Acute otitis media may be associated with sepsis, though the association is not very common. Facial nerve palsy is a rare complication of otitis media in neonates. Other more common causes of facial nerve palsy are traumatic (birth trauma) and idiopathic (Bell’s palsy). Through this article, we report a rare case of facial nerve palsy secondary to otitis media in a neonate with sepsis.

To Determine the Efficacy of Pentoxifylline in the Management of Bell's Palsy.

Bell's palsy is an acute, unilateral, lower motor neuron peripheral facial paralysis. It is the most common cause of facial paralysis in the ages ranging from 13 to 65 years. It not only causes physical disfigurement of face but is also associated with social stigma and psychological trauma to the patient. In Bell's Palsy, there is hypoxic damage to the nerve due to reduced blood flow and cellular injury to the capillaries. Pentoxifylline is a phosphodiesterase inhibitor that increases the cAMP and cGMP levels at the site of the RBC cell membrane thereby improving the dexterity of the cell membrane allowing the RBCs to pass through the damaged and narrowed blood vessels thereby improving the perfusion and oxygen delivery to the damaged tissues. Vasoactive agents are not routinely used as an active component in the treatment. Since vascular compromise plays a predominant role in the pathophysiology of Bell's palsy, it is proposed that the addition of a vasoactive agent like Pentoxifylline can improve the recovery rate and shorten the duration of treatment in the management of Bell's Palsy. The study was conducted in the Department of ENT, BMCRI, Bangalore during the period February 2021 to August 2022. This is a prospective randomized control study which included 70 patients attending the out-patient department of ENT, Bangalore Medical College and Research Institute, Bangalore. Written informed consent was taken from all patients included in the study. A detailed history, thorough clinical examination, and relevant investigations were done for these patients. Patients were randomly divided into Group A and Group B based on random numbers generated by the WINPEPI software version 11.65. The study group (Group A) received standard treatment in addition to Tab Pentoxifylline 400mg TID for 1 week. The control group (Group B) received only the standard treatment regimen. Patients were followed up on Days 5, 10, 15, and 6 months to assess recovery following treatment. The recovery of facial nerve function was evaluated as per the House-Brackmann Grading system for any improvement. Both pre-treatment and post-treatment HB grades were analyzed. The data collected were tabulated and subjected to statistical analysis using ANOVA. The age distribution of the patients showed that the most common age group affected in this study was 18-30 years. Males were affected more than females (1.2:1). The most common HB grade at presentation noted in this study was Grade 4 in both groups (54.2%). At the beginning of the treatment, in Group A, around 43% patients had HB grade of 3 and 57% patients had HB grade of 4. In Group B, around 20% patients had HB grade 2, 28.57% patients with grade 3 and 51.43% patients with grade 4. After a follow-up period of 6 months, in Group A, around 43% of patients achieved a HB grade of 1, 51% patients achieved a grade of 2 and about 6% patients had a grade of 3. In Group B after a follow up period of 6 months, 29% patients achieved HB grade of 1, 46% patients achieved grade of 2 and 26% patients had a grade of 3. It was observed that 42.86% of patients had better outcomes (Normal facial function) in Group A (Study group) compared to 28.57% of patients in Group B (Control group). It is evident that a patient who presented with HB grades of 2 or 3 and who presented within 5 days had better chances of recovery which was statistically significant (p = 0.001). From the present study, it may be concluded that Bell's palsy occurs in all age groups. It affects younger age groups more commonly (2nd decade) and affects males more than females. The study group who had received Tab Pentoxifylline along with standard treatment had better outcome. This highlights the benefit of vasoactive agent in the management of Bell's palsy by improving the oxygen delivery to the affected tissues. The online version contains supplementary material available at 10.1007/s12070-023-04298-9.

Efficacy of adding selective electrical muscle stimulation to usual physical therapy for Bell's palsy: immediate and six-month outcomes.

Bell's palsy is the most common cause of facial paralysis, affecting one in every 60 people in their lifetime. Transcutaneously applied selective electrical muscle stimulation could potentially accelerate recovery from Bell's palsy but this intervention remains controversial. Studies have shown benefit, but concerns for lack of efficacy and potential for worsening synkinesis remain. We performed a prospective controlled trial comparing outcomes at initial recovery and six months later with selective electrical muscle stimulation and usual physical therapy versus usual physical therapy alone in adults with acute Bell's palsy. Outcomes were facial function assessed with the House Brackman and eFACE scales. Outcomes were evaluated at discharge and six months after discharge. Discharge occurred when participants were judged to be fully recovered by their treating therapist and supervisor. 38 adults participated in the study. Participants in the electrical stimulation group achieved maximal recovery twice as fast as the control group (2.5 weeks versus 5.2 weeks) with no significant differences in facial function or synkinesis between groups at any time point. This study is the first human trial of electrical stimulation in Bell's palsy to follow patients 6 months from recovery and supports that selective electrical muscle stimulation accelerates recovery and does not increase synkinesis.

Clinical Characteristics of 802 Patients with Facial Palsy: Based on Literature Related to Stomach Meridian

Objectives: The purpose of this study was to suggest the clinical characteristics and risk factors of facial palsy from the perspective of Korean Medicine.Methods: Medical records of 856 patients, who visited the Korean Medicine hospital with facial palsy from 2004 to 2019, were retrospectively analyzed. The clinical characteristics of facial palsy were suggested by figuring out the distribution of age, sex, occupation, onset season, obesity, modes, signs, symptoms, past and family history.Results: By gender, there were more males (54.6%), and the most common age groups were in their 50s (27.4%) and 40s (23.6%). As for the occupation, unemployed (27.7%) and service and sales workers (14.6%) were the most common, and the onset season was the most common in winter (28.9%). The most common clinical characteristics were overwork (33.0%), mental stress (24.8%), and exposure to cold (19.3%) in modes, ‘none’ (64.3%), postauricular pain (33.2%) in signs, postauricular pain (26.9%), parageusia (14.8%) in symptoms. Hypertension and diabetes were the most common in both past and family history. In particular, the obesity rate of the subjects (59.8%) was much higher than that of Koreans (32.8%).Conclusions: Based on the historical Korean Medicine literature and the results of this study, it is suggested that overwork, stress, exposure to cold, and obesity are identified as risk factors for facial palsy. Furthermore, dysfunction of the stomach meridian is thought to contribute to the cause of facial palsy.

Classification of benign and malignant parotid tumors based on CT images combined with stack generalization model.

Parotid tumors are among the most prevalent tumors in otolaryngology, and malignant parotid tumors are one of the main causes of facial paralysis in patients. Currently, the main diagnostic modality for parotid tumors is computed tomography, which relies mainly on the subjective judgment of clinicians and leads to practical problems such as high workloads. Therefore, to assist physicians in solving the preoperative classification problem, a stacked generalization model is proposed for the automated classification of parotid tumor images. A ResNet50 pretrained model is used for feature extraction. The first layer of the adopted stacked generalization model consists of multiple weak learners, and the results of the weak learners are integrated as input data in a meta-classifier in the second layer. The output results of the meta-classifier are the final classification results. The classification accuracy of the stacked generalization model reaches 91%. Comparing the classification results under different classifiers, the stacked generalization model used in this study can identify benign and malignant tumors in the parotid gland effectively, thus relieving physicians of tedious work pressure.

Evidence-Based Practices in Facial Reanimation Surgery.

After studying this article, the participant should be able to: 1. Describe the causes and preoperative evaluation of facial paralysis. 2. Discuss techniques to restore corneal sensation and eyelid closure, elevation of the upper lip for smile, and depression of the lower lip for lip symmetry. 3. Outline treatment goals, surgical treatment options, timing of repair, and other patient-specific considerations in appropriate technique selection. Congenital facial paralysis affects 2.7 per 100,000 children; Bell palsy affects 23 per 100,000 people annually; and even more people are affected when considering all other causes. Conditions that impair facial mimetics impact patients' social functioning and emotional well-being. Dynamic and static reconstructive methods may be used individually or in concert to achieve adequate blink restoration, smile strength and spontaneity, and lower lip depression. Timing of injury and repair, patient characteristics such as age, and cause of facial paralysis are all considered in selecting the most appropriate reconstructive approach. This article describes evidence-based management of facial paralysis.

BELL'S PALSY IN PREGNANCY AND PUERPERIUM: A CASE REPORT

Bell's Palsy is an idiopathic facial nerve palsy and also the most common cause of facial nerve palsy. It's incidence is 17/100,000 population per year in women of child bearing age group(WCBA). We, hereby present a case of 26 year old gravida 2, para 1, living 1 with 35 weeks of gestation who presented with gradual onset of facial weakness and few other complaints which after thorough examination were suggestive of Bell's palsy in a case of pre eclampsia. Patient was later posted for C-section at 36 weeks for scar tenderness. In the post operative period patient was on steroids for persistent facial nerve palsy but the patient landed in an unusual complication due to on going steroids as she had failed to follow up. Patient was taken up for exploratory laparotomy, patient tolerated the procedure well and went home on POD-42. Amongst the medications used in this patient for Bell's palsy, we saw that steroids could thus act as a double edged sword and thus close monitoring, follow up and patient compliance is equally important

Etiologies, periocular manifestations and surgeries for congenital and childhood acquired facial nerve palsy

To report periocular surgeries performed for patients with congenital and childhood acquired facial nerve palsy (FNP). A retrospective case series of pediatric patients who presented with FNP over the last 34years, was conducted at two tertiary eye hospitals in Riyadh. Data were collected from electronic charts, hospital records and external photos. Main outcome measures were visual acuity, lagophthalmos, eyelid abnormalities, Bell's phenomena, exposure keratopathy, and corneal scar; in these cases, periocular surgeries were required. Among the 90recruited subjects; the mean age of onset was 4.8±5.4years old (range, 0.01 to 17.76years). Traumatic and congenital causes of FNP were the most common, representing over 80% of the cases. Seventy-one patients developed lagophthalmos, 26 with severe exposure that resulted in scarring. Thirty-six (40%) cases had associated strabismus. Lower lid retraction was the most common eyelid abnormality noted in 23cases, followed by entropion in 16 and ectropion in 6cases. Temporary tarsorrhaphy was performed in three patients (3.3%), while 18patients (20%) needed permanent tarsorrhaphy. Gold weight implants were placed in 17patients (18.9%). Lower lid retraction repair was performed in twelve patients (13.3%). Five patients (5.6%) underwent lower eyelid entropion repair, and three patients (3.3%) underwent lower eyelid ectropion repair. Lagophthalmos is the most common finding in children presenting with FNP and needs to be managed early to prevent permanent visual loss. Compared to adults, children may present with a different spectrum of eyelid abnormalities, with lower lid retraction and entropion being the most common eyelid malpositions.

Gender-Specific Evaluation Following McLaughlin’s Dynamic Muscle Support for Irreversible Facial Paralysis

Failure of the mimic muscles as a cause of facial nerve paralysis may result in significant asymmetry, which can be addressed by surgical reanimation procedures. Among those, the temporalis muscle transfer as advocated by McLaughlin is a single-stage technique for the dynamic reanimation of the mouth. Despite increasing research directed at women’s health, the gender-specific differences of this technique have not yet been addressed. Thus, we retrospectively reviewed the medical records of patients who underwent this operation between 2001 and 2021 for gender-specific differences concerning the postoperative outcome. In total, 28 women and 17 men were included. The two cohorts were statistically comparable with respect to etiological characteristics such as age, duration and etiology of paralysis, and preoperative degree of symptoms. After a median follow up of 15 months, restoration of smiling and elevation of the oral commissure was more often achieved among women than men. A statistically significant difference, however, could only be shown for the latter. Resting symmetry was restored in about 50% of both genders. There were no differences concerning postoperative complications or reoperations. The McLaughlin’s dynamic muscle support effectively re-establishes the elevation of the oral commissure and ability to smile among both genders, albeit women tend to be more likely to achieve the desired results.

Acute otitis media-related facial nerve palsy in a child: a case report and a literary review

BackgroundAcute otitis media has become a rare cause of facial palsy in children. A high index of suspicion is essential to achieve the diagnosis and to properly treat this condition to avoid permanent neurological sequelae.Case presentationA case of acute otitis media-related facial nerve palsy in an 18 months-old child is described and a review of the recent literature about the clinical presentation, diagnosis, and management of this condition is performed.ConclusionsFacial paralysis is an uncommon complication of acute otitis media that requires appropriate care. As highlighted in our report, the treatment of facial nerve palsy secondary to otitis media should be conservative, using antibiotics and corticosteroids. The role of antiviral is still a matter of debate. Myringotomy and a ventilation tube should be added when spontaneous perforation of the tympanic membrane is not present. More aggressive surgical approach should be considered only when there is no significant improvement.

An unusual cause of facial nerve palsy affecting a mum and her child with literature review and analysis for other causes

An unusual cause of facial nerve palsy affecting a mum and her child with literature review and analysis for other causes

Clinical Study on the Causes and Outcome of Facial Nerve Palsy at Liaquat University Hospital Hyderabad

Background and Aim: A facial paralysis can be enormously distressing for a person. In order to restore and rehab face symmetry, it is essential to understand the source and type of nerve damage. Lower motor neuron facial paralysis was investigated in the current study to assess its various causes. Patients and Method: This prospective study was carried out on 48 facial nerve palsy (FNP) in the Department of Medicine, Liaquat University Hospital, Hyderabad from January 2021 to August 2022. Patients diagnosed with peripheral facial nerve paralysis of any age and both genders were enrolled. Patient’s details such as time of symptom onset, paralysis duration, rapidity of progression, and paralysis completeness were evaluated. Each individual was interviewed about family history, medical illness such as malignancy, tuberculosis, diabetes, autoimmune disorders, previous episodes, any prior surgery, trauma history, and related symptoms such as neurological, auditory, and vestibular. Lesion site and treatment response was administered by Topo diagnostic tests. Data analysis was carried out in SPSS version 26. Results: Out of 48 FNP patients, 34 (70.8%) were male and female 14 (29.2%) respectively. The overall mean age was 35.8±6.2 years with an age range 5 to 70 years. Patients were distributed into different age groups as follows: 6 (12.5%) in 5-20 years, 19 (39.6%) in 21-35 years, 16 (33.3%) in 36-50 years, and 7 (14.6%) in 51-70 years. The prevalence of left and right side affected patients were 20 (41.7%) and 28 (58.3%) respectively. The most prevalent causes of FNP were idiopathic and external trauma found in 12 (25%) cases followed by infections and tumour found in 8 (16.7%) cases. Severity of paralysis calculated based on H. Brackman grading were as follows: Grade IV, V, and VI paralysis were found in 22 (45.8%), 8 (16.7%), and 2 (4.2%) respectively. Physiotherapy and conservative treatment was given to 26 (54.2%) patients followed by facial nerve surgery in 14 (29.2%) patients. Conclusion: The present study found that External trauma and Bell's palsy are the leading causes of LMN facial nerve paralysis. The right side was more affected than the left side, and male patients predominated. Upon presentation, most lesions were suprageniculate and had House Brackmann severity scores of IV. After a one-year follow-up, most of our peripheral facial paralysis cases had recovered fully or partially. Keywords: Facial nerve palsy, Outcomes, Causes, House Brackmann severity.

Bell's Palsy and Its Semantic Change over Time.

From 1821 to 1829, Sir Charles Bell presented cases of facial paralysis from infection, trauma, and unknown causes. As such, "Bell's palsy" initially referred to facial palsy of any etiology. Today, the term is reserved for idiopathic peripheral facial palsy. The objectives of this analysis were to establish when the eponym came to vogue and delineate the semantic shift from its original definition to its current one. Extensive review of available 19th and 20th century literature mentioning "Bell's palsy" and "Bell's paralysis." Historical accounts have eponymously attached Bell's name to facial paralysis as early as the 1840s-Bell's palsy was first used to describe cases of facial palsy of any cause. In 1886, Gowers characterized Bell's palsy as a "neuritis usually within the Fallopian Canal," distinguishing it as a separate etiology. Over the next decades, the definition narrowed to peripheral facial paralysis from cold exposure or unknown causes. By the 1940s, its natural history was well described-an acute, unilateral, idiopathic, and usually self-limited peripheral facial palsy. The semantic change of a word over time can tell us a remarkable story of its history and origins. Absence of a discrete lesion, lack of proven treatment, and good prognosis without intervention distinguished Bell's palsy from other causes of facial paralysis. Over time, the definition has narrowed from a facial palsy of any cause to an idiopathic peripheral facial palsy. Recent evidence supporting Bell's palsy as a viral mononeuritis may have driven its recent semantic change toward this specific etiology.

ELECTROPHYSIOLOGIC PATTERN OF FACIAL MUSCLE INVOLVEMENT IN BELL'S PALSY

Introduction: Idiopathic Bell's Palsy is the commonest cause of Facial nerve palsy accounting for 45% to 71% of all causes of Facial Palsy. Electrophysiological evaluation comprises of Nerve conduction studies(NCS), Blink response and Electromyography(EMG) Methods: This was a prospective cross-sectional study done among 50 consecutive patients with Bell's Palsy who were evaluated and diagnosed within 1 week after onset of symptoms. Patients with facial palsy with a normal MRI and normal hematological and biochemical parameters were labelled as Bell's Palsy and were subjected to an NCS. Latency and CMAP recordings were obtained from Orbicularis Oculi, Nasalis and Orbicularis Oris. Results: Fifty patients were included in this study (27 male and 23 female). Most patients belonged to the age group of 41 - 60 years. One-Half(25) of the included patients had palsy of the Facial nerve on the right side and the others on the Left side. Forty-one(82%) of included patients had electrophysiological involvement of the orbicularis oculi as dened by a decrease in CMAP of more than 50% compared to the normal side. Similarly, 41(82%) patients had electrophysiological abnormality of the Nasalis muscle and 26(52%) patients had decreased CMAP of the Orbicularis Oris Muscle. The most frequent electrophysiologic pattern observed in this study in the rst week was involvement of all 3 muscles studied i.e., Orbicularis Oculi, Nasalis and Orbicularis Oris. Conclusion: In the rst week of illness, electrophysiological abnormality was most frequently seen in Orbicularis Oculi and Nasalis muscles. Follow-up electrophysiological studies are required to know the pattern of progression