Facial palsy

Facial palsy represents apparently a trivial mononeuropathy, which is considered to be identical with Bell's palsy, the idiopathic facial palsy. It is ordinarily a manifestation of nuclear impairment or direct lesion of the facial nerve, a mononeuropathy, of an infectious or inflammatory origin. A relation between minimally 50 % peripheral facial palsies with herpes simplex virus 1, varicella zoster virus and bacterial infections, particularly borrelias and mycoplasmas, has been proved. Central and nuclear palsies are described with regard to complicated and underestimated differential diagnostics. The basic data on the heterogeneous entity of diseases associated with impairments of the intermediofacial nerve concerning infectious, demyelinating diseases, vascular, metabolic and degenerative diseases, tumors and injuries, are given. Data on epidemiology, etiology and diagnostic methods: laboratory, electrophysiological, neuroimaging, serological-immunological, and molecular-biological are presented. A survey of therapeutic procedures based on the use of anti-herpetic drugs, antibiotics, corticosteroids, symptomatic drugs and rehabilitation summarizes discrepant opinions of the effectiveness of therapy/management and clinical trials, which prevailingly do not meet the requirements of the evidence-based medicine.