Snapshot A 42 year-old with a history of hypertension and diabetes presents with acute onset of right facial weakness and numbness. She says she recently recovered from a URI. On examination her speech and extremity strength are normal, but she has significant weakness on the right side of the face, including the orbicularis oculi. In addition, she complains of roaring in the right ear, and her taste sensation is absent on the right side of the anterior tongue. Sensation is normal to pinprick. Introduction Bell's palsy is idiopathic facial nerve palsy is associated with lyme disease (borrelia burgodorferi) Nearly always acute Caused by damage to 7th (Facial) cranial nerve Can strike anyone at any age, however disproportionately affects pregnant women diabetic patients or patients with a cold or respiratory ailment Likely cause is herpes simplex virus Presentation Symptoms facial numbness and weakness hearing abnormalities loss of taste sensation Treatment Recent studies show improvement with steroids acyclovir Eye ointment to protect the eye from drying at nighttime Analgesic for pain Prognosis, Prevention, and Complications Prognosis is very good with or without treatment most patients begin to get significantly better within 2 weeks 80% recover completely within 3 months. Symptoms may last longer and may never completely disappear