Topic Overview
What is Bell's palsy?
Bell's palsy is a
paralysis or weakness of the muscles on one side of
your face. Damage to the facial nerve that controls muscles on one side of the
face causes that side of your
face to droop. The nerve damage may also affect your sense of taste and how you
make tears and saliva. This condition comes on suddenly, often overnight, and
usually gets better on its own within a few weeks.
Bell's palsy
is not the result of a
stroke or a
transient ischemic attack (TIA). While stroke and TIA
can cause facial paralysis, there is no link between Bell's palsy and either of
these conditions. But sudden weakness that occurs on one side of your face should be checked by a doctor right away to rule out these more serious causes.
What causes Bell's palsy?
The cause of Bell's
palsy is not clear. Most cases are thought to be caused by the
herpes virus that causes cold sores.
In most cases of Bell's palsy, the nerve that
controls muscles on one side of the face is damaged by
inflammation.
Many health problems can
cause weakness or paralysis of the face. If a specific reason cannot be found
for the weakness, the condition is called Bell's palsy.
What are the symptoms?
Symptoms of Bell's palsy include:
- Sudden weakness or paralysis on one side of your face that causes it
to droop. This is the main symptom. It may make it hard for you to close your eye on that side of your
face.
- Drooling.
- Eye problems, such as
excessive tearing or a dry eye.
- Loss of ability to
taste.
- Pain in or behind your ear.
- Numbness in the
affected side of your face.
- Increased sensitivity to sound.
How is Bell's palsy diagnosed?
Your doctor may
diagnose Bell's palsy by asking you questions, such as about how your symptoms
developed. He or she will also give you a physical and neurological exam to
check
facial nerve function.
If the cause of your symptoms is not clear, you may need other tests, such as blood tests, an MRI, or a CT scan.
How is it treated?
Most people who have Bell's
palsy recover completely, without treatment, in 1 to 2 months.footnote 1
This is especially true for people who can still partly move their facial muscles. But a small number of people may have permanent muscle weakness or other problems on the
affected side of the face.
Treatment with corticosteroid medicines (such as prednisone) can make it more likely that you will regain all facial movement. They work best if they are taken soon after symptoms start (within 3 days).
Sometimes antiviral medicines (such as acyclovir) may be added to corticosteroid medicines to treat Bell's palsy. But evidence for using antiviral medicines is weak. They may help in some cases, but in general they do not affect recovery.footnote 2
Some people may not be able to take corticosteroid medicines because of other health problems. It's important to remember that most people with Bell's palsy recover completely without any treatment.
How can you care for yourself at home?
Facial exercises. As the nerve in your face begins to work again,
doing simple exercises-such as tightening and relaxing your facial muscles-may
make those muscles stronger and help you recover more quickly. Massaging your
forehead, cheeks, and lips with oil or cream may also help.
Eye care. If you can't blink or close your eye fully, your eye may become dry. A dry eye can lead to sores and serious vision problems. To help protect the eye and keep it moist:
- Use your finger to close and open your
eyelid often throughout the day.
- Use
eyedrops ("artificial tears") or ointment. Those that contain methylcellulose are a good choice and don't require a prescription. You may want to use drops during the day and ointment at night while you sleep. Ask your doctor how often to use the
drops.
- Wear an eye patch while you sleep, and wear glasses or goggles the rest of the time.
Mouth care. If you have no feeling and little
saliva on one side of your tongue, food may get stuck there, leading to
gum disease or
tooth decay. Brush and floss your teeth often
and well to help prevent these problems. To prevent
swallowing problems, eat slowly and chew your food well. Eating
soft, smooth foods, such as yogurt, may also help.