Learn more about Bell's palsy, which causes temporary facial paralysis. Find out why Bell's palsy happens and what to do about it.
The symptoms of Bell's palsy include sudden weakness in your facial muscles. In most cases, the weakness is temporary and significantly improves over weeks. The weakness makes half of your face appear to droop. Your smile is one-sided, and your eye on that side resists closing.
Bell's palsy, also known as acute peripheral facial palsy of unknown cause, can occur at any age. The exact cause is unknown. It's believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. Or it might be a reaction that occurs after a viral infection.
For most people, Bell's palsy is temporary. Symptoms usually start to improve within a few weeks, with complete recovery in about six months. A small number of people continue to have some Bell's palsy symptoms for life. Rarely, Bell's palsy can recur.
Signs and symptoms of Bell's palsy come on suddenly and may include:
In rare cases, Bell's palsy can affect the nerves on both sides of your face.
Seek immediate medical help if you experience any type of paralysis because you may be having a stroke. Bell's palsy is not caused by a stroke, but it can cause similar symptoms.
See your doctor if you experience facial weakness or drooping to find out the underlying cause and severity of the illness.
Although the exact reason Bell's palsy occurs isn't clear, it's often related to having a viral infection. Viruses that have been linked to Bell's palsy include viruses that cause:
The nerve that controls your facial muscles passes through a narrow corridor of bone on its way to your face. In Bell's palsy, that nerve becomes inflamed and swollen — usually related to a viral infection. Besides facial muscles, the nerve affects tears, saliva, taste and a small bone in the middle of your ear.
Bell's palsy occurs more often in people who:
Recurrent attacks of Bell's palsy are rare. But in some of these cases, there's a family history of recurrent attacks — suggesting a possible genetic predisposition to Bell's palsy.
A mild case of Bell's palsy normally disappears within a month. Recovery from a more severe case involving total paralysis varies. Complications may include:
There's no specific test for Bell's palsy. Your doctor will look at your face and ask you to move your facial muscles by closing your eyes, lifting your brow, showing your teeth and frowning, among other movements.
Other conditions — such as a stroke, infections, Lyme disease and tumors — can cause facial muscle weakness that mimics Bell's palsy. If the cause of your symptoms isn't clear, your doctor may recommend other tests, including:
Most people with Bell's palsy recover fully — with or without treatment. There's no one-size-fits-all treatment for Bell's palsy, but your doctor may suggest medications or physical therapy to help speed your recovery. Surgery is rarely an option for Bell's palsy.
Commonly used medications to treat Bell's palsy include:
Antiviral drugs. The role of antivirals remains unsettled. Antivirals alone have shown no benefit compared with placebo. Antivirals added to steroids are possibly beneficial for some people with Bell's palsy, but this is still unproved.
However, despite this, valacyclovir (Valtrex) or acyclovir (Zovirax) is sometimes given in combination with prednisone in people with severe facial palsy.
Paralyzed muscles can shrink and shorten, causing permanent contractures. A physical therapist can teach you how to massage and exercise your facial muscles to help prevent this from occurring.
In the past, decompression surgery was used to relieve the pressure on the facial nerve by opening the bony passage that the nerve passes through. Today, decompression surgery isn't recommended. Facial nerve injury and permanent hearing loss are possible risks associated with this surgery.
Rarely, plastic surgery may be needed to correct lasting facial nerve problems. Facial reanimation helps to make the face look more even and may restore facial movement. Examples of this type of surgery include eyebrow lift, eyelid lift, facial implants and nerve grafts. Some procedures, such as an eyebrow lift, may need to be repeated after several years.
Home treatment may include:
Although there's little scientific evidence to support the use of alternative medicine for people with Bell's palsy, some people with the condition may benefit from the following:
You'll likely start by seeing your family doctor. However, in some cases when you call to set up an appointment, you may be referred immediately to a neurologist.
It's good to prepare for your appointment. Here's some information to help you get ready.
Preparing a list of questions will help you make the most of your time with your doctor. For Bell's palsy, some basic questions to ask your doctor include:
Don't hesitate to ask any additional questions that occur to you during your appointment.
Be prepared to answer questions from your doctor, such as:
If you have facial pain:
If your eye won't close completely, try these tips:
April 2nd, 2020