Bell's Palsy

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Bell's palsy is the most common cause of facial paralysis on one side. This face droop is usually temporary. And it isn’t life-threatening.

Any new facial paralysis may be an emergency. Get medical help right away. Treatment for Bell's palsy works best if it's started in the first three days. 

If your facial paralysis isn’t getting better, you probably need a specialist. At UVA, our experts have the tools and experience to give you the options you need.

Bell's Palsy Treatment

If we discover the underlying cause of your facial paralysis, we may be able to treat it. Treatment for these underlying conditions may include medication or surgery. 

If you're diagnosed with Bell's palsy without a clear cause, we'll likely start medical treatment right away.

Medication

Medicines for treating your Bell’s palsy might include:

  • Corticosteroids, to help swelling and pain
  • Antiviral medication, to fight viruses

Your provider may give you corticosteroids if you’ve only had symptoms for a short time. Antiviral medications might be prescribed along with corticosteroids. Combining these medications can improve your chances of complete recovery. It also reduces the risk of developing complications.

Therapy

Physical therapy can improve the movement in your face. It's especially helpful if movement is already returning to your face.

We also offer emotional support. Bell's palsy can be distressing. We can help you manage your feelings about your condition.

Surgery

We have several options for facial reanimation that can help.

Self-Care

If your eyelid is affected, you’ll need to protect your eye. You might need to:

  • Use eye drops or other lubricants
  • Cover and tape your eye closed at night
  • Use an eye patch

Massaging the weakened face muscles may also help.

    A man showing the classic one-sided face droop seen in cases of stroke.

    Sudden Face Droop? Call 911

    Sudden drooping or weakness on one side of your face is an emergency. You might be having a stroke. Strokes come on suddenly and can be life-threatening.

    If you have sudden facial paralysis, get help immediately. Call emergency services right away.

    Stroke Symptoms

    How Did I Get Bell’s Palsy?

    Usually, we don’t know the exact cause. Sometimes, we find that infections have caused the swelling and paralysis.

    Infections in your nerves might come from:

    • Herpes simplex (usually the cause of Bell's palsy)
    • Shingles or chickenpox (can cause Ramsay Hunt syndrome, a more severe form of Bell's Palsy)
    • Lyme disease (from a tick bite)

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

    • Family members who have Bell's palsy
    • Diabetes
    • Autoimmune disorders
    • Infections (such as HIV, cold, or flu)
    • Weakened immune system
    • Chemotherapy
    • Certain medications
    • Pregnancy
    • Smoking
    • High blood pressure

    Bell’s Palsy Symptoms

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

    • Pain behind the ear followed by weakness and paralysis in your face
    • Ringing sound in your ears
    • Trouble hearing
    • Slight increase in sensitivity to sound on the affected side
    • Changes in taste

    Symptoms of advanced Bell's palsy 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

    Complications can also occur 3-4 months after you first get Bell’s palsy. These symptoms include:

    • Long-lasting tightening of the facial muscles
    • Tearing from the eye while chewing
    • Facial muscle spasm or twitching
    • Involuntary movements of more than one facial muscle at a time (synkinesis)

    Recovery from Bell’s palsy can take up to a full year. But for most people, it goes away after a few months. Symptoms often get better on their own in a few weeks. Your face should return to normal movement. You’ll need to see specialists if you:

    • Develop complications from Bell’s palsy
    • Don’t see any improvement after six months
    • Haven’t recovered after one year

    In certain cases, some symptoms of Bell's palsy don’t go away. You may have lasting weakness, tightening, or spasming in your face muscles. As you get older, it’s more likely you’ll have lasting symptoms.

    Bell’s Palsy: Getting a Diagnosis   

    To evaluate your facial paralysis, we’ll:

    • Check your symptoms with a physical exam
    • Take your medical history
    • If needed, extra tests to check for other causes