Bell Palsy — MFDS Part 1 MCQ
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Correct answer: D — Acute idiopathic unilateral lower motor neurone facial weakness involving the forehead and eye closure
Bell palsy is an acute, idiopathic, unilateral lower motor neurone facial palsy. It weakens all parts of the affected side of the face, including the forehead, and commonly impairs eye closure. This whole-face pattern distinguishes it from a supranuclear upper motor neurone lesion, in which forehead movement is relatively preserved. Bilateral facial weakness is uncommon and should prompt consideration of another diagnosis. Trigeminal nerve dysfunction primarily impairs facial sensation and muscles of mastication rather than facial expression. Hypoglossal nerve palsy causes ipsilateral tongue weakness, not facial paralysis. Bell palsy is a diagnosis of exclusion because identifiable causes such as middle-ear disease, Ramsay Hunt syndrome, trauma or a mass lesion constitute other forms of facial palsy.
Reference: National Institute for Health and Care Excellence. Suspected neurological conditions: recognition and referral (NG127), section 1.7.11, Bell's palsy. Published 2019; last updated 2023. https://www.nice.org.uk/guidance/ng127/chapter/Recommendations-for-adults-aged-over-16