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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.
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.
Symptoms of Bell's palsy include:
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.
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.
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:
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.
Ropper AH, et al. (2014). Diseases of the cranial nerves. In Adams and Victor's Principles of Neurology, 10th ed., pp. 1391–1406. York: McGraw-Hill Education.
Gronseth GS, Paduga R (2012). Evidence-based guideline update: Steroids and antivirals for Bell palsy. Neurology, 79(22): 2209–2213.
Other Works Consulted
Brannagan TH, Weimer LH (2010). Cranial and peripheral nerve lesions. In LP Rowland, TA Pedley, eds., Merritt's Neurology, 12th ed., pp. 503–519. Philadelphia: Lippincott Williams and Wilkins.
De Almeida JR, et al. (2009). Combined corticosteroid and antiviral treatment for Bell palsy: A systematic review and meta-analysis. JAMA, 302(9): 985–993.
Sullivan FM, et al. (2007). Early treatment with prednisolone or acyclovir in Bell's palsy. New England Journal of Medicine, 357(16): 1598–1607.
Current as of: March 28, 2019
Author: Healthwise StaffMedical Review: Anne C. Poinier, MD - Internal MedicineE. Gregory Thompson, MD - Internal MedicineAdam Husney, MD - Family MedicineMartin J. Gabica, MD - Family MedicineKathleen Romito, MD - Family MedicineColin H. Chalk, MD, CM, FRCPC - Neurology
Current as of:
March 28, 2019
Medical Review:Anne C. Poinier, MD - Internal Medicine & E. Gregory Thompson, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Colin H. Chalk, MD, CM, FRCPC - Neurology
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