Bell's Palsy | Right Decisions

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

History

Acute lower motor neurone (involving whole face) facial palsy
May be preceded by 1-2 day history of mild facial/ear pain
Ask about ear symptoms – more severe pain may suggest Ramsay Hunt Syndrome (look for vesicles in ear), if any associated reduced hearing/ear discharge d/w ENT same day

Examination

Assess/document facial movement – eye closure/forehead movement, can use House Brackman Scale (see below)
Examine ear – any features of infection or cholesteatoma then d/w ENT same day
Examine parotid, oropharynx (for deep parotid lobe involvement) and remaining cranial nerves – any abnormalities refer to ENT as Urgent Suspected Cancer

Management - based on Scottish Bells Palsy Study

Treat with oral Prednisilone 25mg X2/day for 10 days
If any suggestion of Ramsay Hunt Syndrome oral Acyclovir 400mg X5/day for 7 days
If unable to close eye easily

- Tape eye closed at night
- Lacrilube to eye at night
- Hypromellose 2-3 eye drops X3/day

Follow up

With Primary Care if not complete resolution in 4 weeks

House Brackman Scale

Last reviewed: 15/06/2023

Next review date: 15/06/2026

Author(s): Carr E.

Version: V1

Author email(s): Esmond.carr@borders.scot.nhs.uk .

Approved By: McCarthy C

Reviewer name(s): Carr E.