Peripheral Facial Paralysis

Overview

A practical and academic on-call approach to acute peripheral facial nerve paralysis. This is not simply a “crooked face” diagnosis. It is a fast decision pathway: first exclude stroke and other dangerous mimics, then protect the cornea immediately, document the degree of facial weakness, start corticosteroids within the therapeutic window when Bell’s palsy is likely, and arrange structured follow-up. The goal is not only to prescribe prednisolone; the goal is to avoid missing a central lesion, Ramsay Hunt syndrome, otitis/mastoiditis, parotid malignancy, or a preventable corneal injury.