The evaluation of facial paralysis.

The clinician faces a major challenge in the evaluation of acute facial nerve paralysis. Not only must he or she differentiate the large proportion of patients with idiopathic palsy who will resolve spontaneously from that critical small group that will not, but must also diagnose correctly the other rather unusual to rare conditions that cause facial paralysis. This article reviews the differential diagnosis, initial clinical evaluation, natural history, and long-term follow up of patients with acute facial dysfunction.