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Facial nerve palsy / Bell’s palsy

Facial nerve palsy / Bell’s palsy

Emergency and immediate referrals

Referral to Emergency Department

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergency medical advice if in a remote region:

  • Ear conditions with associated neurological signs i.e. facial palsy

Immediately contact on-call registrar or service to arrange an immediate neurology assessment (seen within 7 days) for:

  • Nil

To contact the relevant service, please see HealthPathways: Acute Neurology Assessment

Presenting issues
  • Complicated facial nerve palsy (i.e. not isolated acute Bell's palsy)
  • Bell’s palsy worsening, recurrent or new symptoms/signs develop
Mandatory referral information (referral will be returned if this information is not included)

History

  • Neurology/neurosurgery history
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment

Investigations

  • Diagnostic audiology assessment (where available and providing it will not cause significant delay)

If unable to attach reports, please include relevant information/findings in the body of the referral

Referrer to state reason if not able to include mandatory information in referral (e.g. patient unable to access test due to geographical location or financial cost)
Highly desirable referral information
  • Fine cut/slice CT scan of temporal bone results
Indicative triage category
Indicative triage category
Category 1
Appointment within 30 days
  • Lower motor neuron palsy and any of the following:
    • hearing loss
    • suspected other cranial nerve involvement
  • Lower motor neuron palsy and otalgia and/or otorrhoea
  • Vesicles in tympanic membrane and otalgia and/or otorrhoea
  • Perineural spread from cutaneous SCC with or without sensory changes e.g. tingling, numbness
  • Facial palsy associated with trauma
Category 2
Appointment within 90 days
  • No category 2 criteria             
Category 3
Appointment within 365 days
  • No category 3 criteria             
Excluded neurology services

Referral to public adult neurology outpatient services is not routinely accepted for the following conditions:

Condition Details (where applicable)
Uncomplicated Bell's Palsy
Last reviewed: 29-06-2023

More information

Email: DOHSpecialistRAC@health.wa.gov.au

wa.gov.au