Facial paralysis: Clinical practice guideline of the Spanish Society of Otolaryngology

Acta Otorrinolaringol Esp (Engl Ed). 2020 Mar-Apr;71(2):99-118. doi: 10.1016/j.otorri.2018.12.004. Epub 2019 May 13.
[Article in English, Spanish]


Bell's palsy is the most common diagnosis associated with facial nerve weakness or paralysis. However, not all patients with facial paresis/paralysis have Bell's palsy. Other common causes include treatment of vestibular schwannoma, head and neck tumours, iatrogenic injuries, Herpes zoster, or trauma. The approach to each of these conditions varies widely. The purpose of this guideline is to provide clinicians with guidance on the treatment and monitoring of patients with different causes of facial paralysis. We intend to draft a practical guideline, focusing on operationalised recommendations deemed to be useful in the daily management of patients. This guideline was promoted by the Spanish Society of Otolaryngology and developed by a group of physicians with an interest in facial nerve disorders, including at least one physician from each Autonomous Community. In a question and answer format, it includes 56 relevant topics related to the facial nerve.

Keywords: Alteraciones del nervio facial; Bell's palsy; Facial nerve disorders; Facial nerve pathophysiology; Facial paralysis; Fisiopatología del nervio facial; Parálisis de Bell; Parálisis facial.

Publication types

  • Practice Guideline

MeSH terms

  • Age Factors
  • Bell Palsy / diagnosis
  • Bell Palsy / therapy*
  • Diagnosis, Differential
  • Diagnostic Imaging
  • Emergencies
  • Facial Paralysis / diagnosis
  • Facial Paralysis / etiology
  • Facial Paralysis / therapy*
  • Female
  • Humans
  • Ophthalmology
  • Otolaryngology*
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Referral and Consultation
  • Societies, Medical*
  • Spain