Bell's Palsy

Definition

Bell's palsy is a sudden weakness or paralysis on one side of the face which may occur without an obvious explanation. However, it is usually a temporary condition. Recovery rate decreases with increasing age.

Bell's Palsy: Facial Droop
Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.

Causes

The exact cause of Bell's palsy is unknown. It is thought to be a result an infection or inflammation in the nerve.

Nerve infections include:

Risk Factors

Factors that may increase your risk of Bell's palsy include:

Symptoms

Bell's palsy symptoms may come on suddenly or develop over a few days. Initial symptoms may include:

  • Pain behind the ear that is followed by weakness and paralysis of the face
  • Ringing sound in the ears
  • Slight hearing impairment
  • Slight increase in sensitivity to sound on the affected side.

Symptoms of full-blown Bell's palsy may include:

  • Facial weakness or paralysis, most often on one side
  • Numbness just before the weakness starts
  • Drooping corner of the mouth
  • Drooling
  • Decreased tearing
  • Inability to close an eye, which can lead to:
    • Dry, red eyes
    • Ulcers forming on the eye
    • Infection
  • Problems with taste on one side
  • Sound sensitivity in one ear
  • Earache
  • Slurred speech

Late complications can occur 3-4 months after onset and can include:

  • Long-lasting tightening of the facial muscles
  • Tearing from eye while chewing

Symptoms will often go away on their own within a few weeks. Bell's palsy may completely resolve after a few months in many people. In some cases, some symptoms of Bell's palsy may never go away.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. The diagnosis is usually made with just the physical exam. The doctor may use information from your health and medical history to determine a potential cause.

Concern about infections or other specific causes may require further testing.

Treatment

For most, treatment is not needed. Your doctor may refer you to a specialist if you have eye problems, if your symptoms worsen, or if your recovery takes longer than expected.

If an underlying cause of the Bell's palsy is known, it may be treated. Treatment for underlying conditions may include medication or surgery.

Medication

Your doctor may prescribe corticosteroids if your symptoms have been present for a short time. This is a medication that can decrease swelling and pain.

Antiviral medications along with corticosteroids may be recommended. There is no evidence that antiviral medication alone has any benefit.

Self-care

If the paralysis includes your eyelid, you may need to protect your eye. This may include:

  • Lubricant or eye drops
  • Covering and taping eye closed at night
  • An eye patch to keep the eye closed

Massaging of the weakened facial muscles may also help.

Therapy

Physical therapy may be advised to improve function.

Symptoms can be very distressing. Counseling can help you manage emotional issues and make appropriate adjustments.

Prevention

There are no current guidelines to prevent Bell's palsy.

Revisions

All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at HLEditorialTeam@ebscohost.com.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Editorial Policy | Privacy Policy | Terms and Conditions | Support
Copyright © 2008 EBSCO Publishing. All rights reserved.

Swelling, pain, redness and increased warmth in a leg may be warning signs of a life-threatening deep vein blood clot. If you have these symptoms, call your family physician or go directly to the Emergency Department.