Bell's palsy is a sudden weakness and paralysis on one side of the face. It is usually a temporary condition however, recovery rate decreases with increasing age.
The exact cause of Bell's palsy is unknown. It occurs as a result of pressure on the nerve, or an infection or inflammation in the nerve.
Pressure may be caused by:
- Tumors or cancers pressing on the nerve
- Trauma from head or facial injuries
Nerve infections include:
Factors that may increase your risk of Bell's palsy include:
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
- Decreased tearing
Inability to close an eye, which can lead to:
- Dry, red eyes
- Ulcers forming on the eye
- Problems with taste
- Sound sensitivity in one ear
- 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
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
- Blood tests
- Hearing test
- Lumbar puncture to test the fluid around the spine and brain
- Electrical test (NCM/EMG)
- Balance test
- Tear test
For most, treatment is not needed. 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. For some people, some symptoms of Bell's palsy may never go away.
If an underlying cause of the Bell's palsy is known, it may be treated. Treatment will be based on that condition.
Your doctor may prescribe corticosteroids. This is a medication that can decrease swelling and pain.
Antiviral medications may also be recommended. This medication may help treat viruses associated with Bell's palsy. It will only be used if your doctor believes the palsy is caused by a virus. Antiviral medication is used in combination with corticosteroids.
Antibiotics for bacterial infections, such as Lyme disease.
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.
Symptoms can be very distressing. Counseling can help you manage emotional issues and make appropriate adjustments.
Physical therapy and speech therapy may also help. Therapists may help reduce your symptoms or decrease their impact on your daily activities.
If you are diagnosed with Bell's palsy, follow your doctor's instructions .
- Reviewer: Rimas Lukas, MD; Michael Woods, MD
- Review Date: 06/2013 -
- Update Date: 00/62/2013 -