House-Brackmann Facial Nerve Grading
Standard grading of facial nerve function (House & Brackmann 1985), used for Bell's palsy, post-parotidectomy, post-acoustic neuroma surgery and other facial palsy. Grades I (normal) to VI (total paralysis).
Score interpretation
→ Reassure. If recent-onset Bell's palsy, complete prednisolone course (50 mg OD ×10 days within 72 h).
→ Eye care critical: lubricants, tape eyelid at night. Steroid course if Bell's <72 h. ENT/neuro-otology review. Consider MRI if not improving by 3 weeks or atypical features.
→ Urgent ENT referral. Eye protection (consider tarsorrhaphy, gold weight, moisture chamber). MRI/MRA to exclude tumour, stroke, Ramsay-Hunt. Discuss facial nerve decompression or rehabilitation (botox, physio, reanimation surgery) if no recovery by 3–6 months.
Interpretation bands for the House-Brackmann. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Valaciclovir (ENT — Ramsay Hunt / Bell's Palsy) · Antiviral (Prodrug of Aciclovir)
- House dust mite extracts · Allergen immunotherapy
- Bupivacaine (Orthopaedic Nerve Blocks) · Local Anaesthetic — Long-acting Amide
- Ropivacaine (Orthopaedic Nerve Blocks) · Local Anaesthetic — Long-acting Amide (S-enantiomer)
- Adult Upper Airway Obstruction (Stridor) · DAS 2015 unanticipated difficult airway; RCEM
- Epistaxis Management · ENT-UK / NICE
- Acute Otitis Media · NICE NG91 2018
- Tonsillitis and Sore Throat · NICE NG84 2018
- Benign Paroxysmal Positional Vertigo · NICE CG124 / AAO-HNS Guidelines
- Acute Rhinosinusitis · NICE NG79 2017 / EPOS 2020
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.