This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Referral criteria from primary care - Bell's Palsy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Referral criteria to secondary care: (1)

  • urgent referral for ear, nose, and throat (ENT) or neurological review if there is:

    • diagnostic uncertainty

    • bilateral Bell's palsy

    • recurrent Bell's palsy

  • refer for urgent ophthalmological review if the cornea remains exposed after attempting to close the eyelid

  • refer urgently to ENT if the paralysis shows no sign of improvement after 1 month, or there is suspicion of a serious underlying diagnosis (e.g. cholesteatoma, parotid tumour, malignant otitis externa)

  • consider referral to a plastic surgeon with a special interest in facial reconstructive surgery If there is residual paralysis after 6-9 months

NICE guidance suggests (2):

  • do not routinely refer adults with an uncomplicated episode of Bell's palsy (unilateral lower motor neurone pattern facial weakness affecting all parts of the face and including weakness of eye closure) and no evidence of another medical condition such as middle ear disease

  • advise adults with Bell's palsy about eye care, and explain that Bell's palsy improves at different rates and maximum recovery can take several months

  • consider referring adults with Bell's palsy who have developed symptoms of aberrant reinnervation (including gustatory sweating or jaw-winking) 5 months or more after the onset of Bell's palsy for neurological assessment and possible treatment.

Reference:


Related pages

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.

The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

Connect

Copyright 2024 Oxbridge Solutions Limited, a subsidiary of OmniaMed Communications Limited. All rights reserved. Any distribution or duplication of the information contained herein is strictly prohibited. Oxbridge Solutions receives funding from advertising but maintains editorial independence.