Learn About Bell's Palsy
Bell palsy is a disorder of the nerve that controls movement of the muscles in the face. This nerve is called the facial or seventh cranial nerve.
Damage to this nerve causes weakness or paralysis of these muscles. Paralysis means that you cannot use the muscles at all.
Facial palsy; Idiopathic peripheral facial palsy; Cranial mononeuropathy - Bell palsy; Bell palsy
Bell palsy can affect people of any age, most commonly those over age 65 years. It can also affect children younger than 10 years. Males and females are equally affected.
Bell palsy is thought to be due to swelling (inflammation) of the facial nerve in the area where it travels through the bones of the skull. This nerve controls movement of the muscles of the face.
The cause is often not clear. A type of herpes infection called herpes zoster might be involved. Other conditions that may cause Bell palsy include:
- HIV/AIDS infection
- Lyme disease
- Middle ear infection
- Sarcoidosis (inflammation of the lymph nodes, lungs, liver, eyes, skin, or other tissues)
Having diabetes and being pregnant may increase the risk for Bell palsy.
Sometimes, you may have a cold shortly before the symptoms of Bell palsy begin.
Symptoms most often start suddenly, but may take 2 to 3 days to show up. They do not become more severe after that.
Symptoms are almost always on one side of the face only. They may range from mild to severe.
Many people feel discomfort behind the ear before weakness is noticed. The face feels stiff or pulled to one side and may look different. Other signs can include:
- Difficulty closing one eye
- Difficulty eating and drinking; food falls out of one side of the mouth
- Drooling due to lack of control over the muscles of the face
- Drooping of the face, such as the eyelid or corner of the mouth
- Problems smiling, grimacing, or making facial expressions
- Twitching or weakness of the muscles in the face
Other symptoms that may occur:
- Dry eye, which may lead to eye sores or infections
- Dry mouth
- Headache if there is an infection such as Lyme disease
- Loss of sense of taste
- Sound that is louder in one ear (hyperacusis)
Often, no treatment is needed. Symptoms often begin to improve right away. But, it may take weeks or even months for the muscles to get stronger.
Your provider may give you lubricating eye drops or eye ointments to keep the surface of the eye moist if you can't close it completely. You may need to wear an eye patch while you sleep.
Sometimes, medicines may be used, but it isn't known how much they help. If medicines are used, they are started right away. Common medicines are:
- Corticosteroids, which may reduce swelling around the facial nerve
- Medicines such as valacyclovir to fight the virus that may be causing Bell palsy
Surgery to relieve pressure on the nerve (decompression surgery) has not been shown to benefit most people with Bell palsy.
University Of Helsinki And Helsinki University Hospital
Mervi Kanerva is in Helsinki, Finland. Kanerva is rated as an Elite expert by MediFind in the treatment of Bell's Palsy. They are also highly rated in 4 other conditions, according to our data. Their top areas of expertise are Bell's Palsy, Melkersson-Rosenthal Syndrome, Facial Paralysis, and Shingles.
University Of Göttingen
Ildiko Gagyor is in Wuerzburg, Germany. Gagyor is rated as an Elite expert by MediFind in the treatment of Bell's Palsy. She is also highly rated in 2 other conditions, according to our data. Her top areas of expertise are Bell's Palsy, Urinary Tract Infection UTI, Drug Induced Dyskinesia, and Facial Paralysis.
Plastic Surgery
Medical University of South Carolina Health System
Epic Center Primary Care
Samuel Oyer is an Otolaryngologist and a Plastic Surgeon in Charleston, South Carolina. Dr. Oyer has been practicing medicine for over 13 years and is rated as a Distinguished doctor by MediFind in the treatment of Bell's Palsy. He is also highly rated in 11 other conditions, according to our data. His top areas of expertise are Facial Paralysis, Recurrent Peripheral Facial Palsy, Bell's Palsy, and Rhinophyma. He is licensed to treat patients in Virginia. Dr. Oyer is currently accepting new patients.
Most cases go away completely within a few weeks to months.
If you did not lose all of your nerve function and symptoms began to improve within 3 weeks, you are more likely to regain all or most of the strength in your facial muscles.
Sometimes, the following symptoms may still be present:
- Long-term changes in taste
- Spasms of muscles or eyelids
- Weakness that remains in facial muscles
Complications may include:
- Eye surface becoming dry, leading to eye sores, infections, and vision loss
- Swelling in the muscles due to loss of nerve function
Call your provider right away if your face droops or you have other symptoms of Bell palsy. Your provider can rule out other, more serious conditions, such as stroke.
There is no known way to prevent Bell palsy.
Published Date : June 23, 2020
Published By : Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
National Institute of Neurological Disorders and Stroke website. Bell's palsy fact sheet. www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Bells-Palsy-Fact-Sheet. Updated May 13, 2020. Accessed August 19, 2020.
Schlieve T, Miloro M, Kolokythas A. Diagnosis and management of trigeminal and facial nerve injuries. In: Fonseca RJ, ed. Oral and Maxillofacial Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 5.
Stettler BA. Brain and cranial nerve disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 95.