Bell's Palsy

Insight into Bell’s palsy, including:

  • What is Bell’s palsy?
  • How is it treated?
  • What if I don’t fully recover?

What is Bell’s palsy?

Bell’s palsy is a fast change to one side of your face resulting in weakness or complete loss of movement. It happens because of damage to the facial nerve of unknown cause.  This makes half of your face seem to droop.  Although Bell’s palsy typically goes away on its own, facial droop or weakness may keep you from closing the affected eye, change how things taste, make your smile crooked, and sometimes may make you drool. 

Bell’s palsy can affect anyone, but is most common in those 15-45 years old.  There are some conditions that put you more at risk such as being overweight, having untreated high blood pressure, diabetes, or upper respiratory illness. 

Most people with Bell’s palsy get better without medical attention within 2-3 weeks. Many recover completely within 3-4 months. Even without any treatment, 70 percent with this palsy get better within six months.

How does the facial nerve change facial expression?

While a virus may cause facial palsy, no one really knows how this works. It may be due to facial nerve swelling (inflammation).  As the nerve travels through a narrow bony canal within the skull, the pressure of such swelling may lead to temporary or permanent facial nerve damage.  The facial nerve not only carries nerve impulses to muscles of the face, but also to the tear glands, salivary glands, muscle of a tiny ear bone, and taste fibers of the tongue.  This means that those with Bell’s palsy may have a dry eye or mouth, taste loss, and a sagging eyelid or mouth corner.

How is Bell’s palsy treated? What will my doctor do?

Facial weakness can be caused by many things. The determination of Bell’s palsy is made when the doctor finds no other cause of your facial weakness.  The doctor will conduct a thorough history and examination, looking for any clear causes of the drooping.  Be sure to tell your doctor about any change or discomfort you notice and when you first noticed a change.  Unless a cause of the problem is found, your doctor is unlikely to do any additional tests, like laboratory testing or imaging.  If your doctor does identify another cause of the facial weakness, then your condition is not Bell’s palsy.

For those 16 years and older, doctors may prescribe steroid medication to calm the swelling, helping the facial nerve to work better.  Studies show that steroids are likely to be helpful. Antiviral treatment may also be of some help for Bell’s palsy when used in addition to steroids.

Protecting your eye

With Bell’s palsy you may have trouble shutting your eye. Not being able to close the eye will cause dryness and may cause pain or eye damage.  So if you do, tell you doctor. He or she may suggest you use eye drops, ointment, or wear an eye patch while you heal.

What else can I do?

You will want to do everything you can to speed recovery, but so far doctors do not know if things like physical therapy or acupuncture help.  Talk to your doctor about what else might help.

What if I don’t fully recover?

Most people with Bells palsy recover completely. For the small percentage of patients who do not fully recover the remaining problems can affect how you feel about yourself and being with others in your day-to-day life.  Certain corrective procedures, such as weighting the eyelid or surgery to improve your smile may help your self-esteem and your appearance.  Talk to your doctor about what might work for you.