Bell's palsy is a sudden weakness or paralysis on one side of the face. It is usually a temporary condition.
The exact cause of Bell's palsy is unknown. It is thought to be a result of an infection or inflammation in the nerve.
Nerve infections include:
- Herpes simplex
- Shingles or chickenpox
Factors that may increase your risk of Bell's palsy include:
- Family members who have Bell's palsy
- Autoimmune disorders
- Infections, such as Lyme disease, HIV, cold, or flu
- Weakened immune system
- Certain medications
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 advanced 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 on one side
- 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
Symptoms will often go away on their own within a few weeks. Bell's palsy may resolve after a few months in many people. In some cases, some symptoms of Bell's palsy may never go away. The recovery rate decreases with increasing age.
You will be asked about your symptoms and medical history. A physical exam will be done. The diagnosis is usually made with just the physical exam. Information from your health and medical history may be used to determine a potential cause.
Concern about infections or other specific causes may require further testing.
For most, treatment is not needed. You may be referred 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.
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 advised. There is no evidence that antiviral medication alone has any benefit.
If the paralysis includes your eyelid, you may need to protect your eye. This may include:
- Lubricant or eye drops
- Covering and taping your eye closed at night
- An eye patch to keep the eye closed
Massaging the weakened facial muscles may also help.
Physical therapy may be advised to improve function.
Symptoms can be distressing. Counseling can help you manage emotional issues and make appropriate adjustments.