When is a consultation with a neurologist or otolaryngologist indicated in patients with suspected Bell palsy (idiopathic facial paralysis) (IFP)?

Updated: Jun 14, 2019
  • Author: Danette C Taylor, DO, MS, FACN; Chief Editor: Selim R Benbadis, MD  more...
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Answer

If the initial diagnostic impression based on the history and physical examination of the patient is not Bell palsy, then consultation with a neurologist or otolaryngologist is needed. For example, consultation with an otolaryngologist should be made for the patient who has facial palsy and pain and in whom the ear, nose, and throat examination does not show auricular vesicles (as in Ramsay Hunt syndrome). These patients should be evaluated for malignancy or other structural lesions of the facial nerve.

Consultation with a neurologist or otolaryngologist should also be sought if the paralysis persists for several months.


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