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When somebody goes to the emergency department or to another physician because of the facial paralysis, whether to see if it’s Bell’s Palsy or not, they are technically doing a diagnosis of exclusion. Meaning: they’re assuming that it’s Bell’s Palsy only if everything else is negative. The things they check for is: they’re going to do blood tests to check for lyme disease, they check for inflammation in the blood via several different tests, they check your white cell count, and they will do some kind of head imaging to make sure that there’s nothing going on inside your ear or your brain that’s causing it rather than the nerve itself. So the first thing you do for Bell’s Palsy is a physical examination. The physical examination is probably 90+% of your diagnosis. The rest is a diagnosis of exclusion. So you do the testing with the imaging in the head, you do the blood testing. If everything else is negative, you are definitively diagnosed as having had Bell’s Palsy and that’s when you assume treatment. That’s when you take the steroids and possibly you’ll get antivirals at the same time – again, just depending on the dealer’s choice.
