Bell’s Palsy OSCE

1. Cranial nerve examination OSCE Bell’s Palsy - Made Easy for Medical Students (OSCE) Cranial nerve examination is important aspect of neurology OSCE for medical students. There are twelve cranial nerves to be examined. Sometimes depending on the examiners command, you may be asked to examine only the upper or lower cranial nerves. Seventh cranial nerve (CN VII) palsy or Bell’s palsy is one of the commonly encountered undergraduate case. It is really easy to identify a patient with lower motor neuron (LMN) type facial nerve palsy or Bell’s palsy due to its characteristic clinical findings. But one should remember that Bell’s phenomenon is different from Bell’s palsy. Facial Nerve Palsy Asymmetry of the face and unable to close the upper eye lid is the most prominent clinical signs to identify a patient with Bell’s palsy. Loss of nasolabial folds, drooling of saliva would supplement your clinical suspicion. Most of the time, diagnosing the facial nerve palsy is not very difficult, but to find the cause. If no cause found, it is called as idiopathic facial nerve palsy or Bell’s palsy. Sometimes the seventh nerve palsy could be secondary to another pathology affecting the facial nerve along its pathway. It can be affected in the internal acoustic meatus, middle ear, parotid gland. A smarter medical student or a doctor should be able to find clues for the cause of the facial nerve palsy once he diagnosed facial nerve palsy. There are great OSCE guidelines which describes stepwise examination of a patient with facial nerve palsy methodically. Also, there are medical educational apps to learn OSCE skills freely available for download which gives many examination guides to short cases in medicine (OSCE skills) for medical students and doctors. You may use those resources to improve your knowledge and use them to guide yourself when you are examining real patients. But examination of patients as much as possible is of utmost importance.