What is Bell’s Palsy?
Bell’s palsy is a condition that causes a temporary weakness or paralysis of the muscles in the face. It can occur when the nerve that controls your facial muscles becomes inflamed, swollen, or compressed.
The condition causes one side of your face to droop or become stiff. You may have difficulty smiling or closing your eye on the affected side. In most cases, Bell’s palsy is temporary and symptoms usually go away after a few weeks.
Although Bell’s palsy can occur at any age, the condition is more common among people between ages 16 and 60. Bell’s palsy is named after the Scottish anatomist Charles Bell, who was the first to describe the condition.
Symptoms of Bell’s Palsy
The symptoms of Bell’s palsy can develop one to two weeks after you have a cold, ear infection, or eye infection. They usually appear abruptly, and you may notice them when you wake up in the morning or when you try to eat or drink.
Bell’s palsy is marked by a droopy appearance on one side of the face and the inability to open or close your eye on the affected side. In rare cases, Bell’s palsy may affect both sides of your face.
Other signs and symptoms of Bell’s palsy include:
- difficulty eating and drinking
- an inability to make facial expressions, such as smiling or frowning
- facial weakness
- muscle twitches in the face
- dry eye and mouth
- sensitivity to sound
- irritation of the eye on the involved side
Call your doctor immediately if you develop any of these symptoms. You should never self-diagnose Bell’s palsy. The symptoms can be similar to those of other serious conditions, such as a stroke or brain tumor.
Causes of Bell’s Palsy
Bell’s palsy occurs when the seventh cranial nerve becomes swollen or compressed, resulting in facial weakness or paralysis. The exact cause of this damage is unknown, but many medical researchers believe it’s most likely triggered by a viral infection.
The viruses/bacteria that have been linked to the development of Bell’s palsy include:
- herpes simplex, which causes cold sores and genital herpes
- HIV, which damages the immune system
- sarcoidosis, which causes organ inflammation
- herpes zoster virus, which causes chickenpox and shingles
- Epstein-Barr virus, which causes mononucleosis
- Lyme disease, which is a bacterial infection caused by infected ticks
Risk factors for Bell’s Palsy
Your risk of developing Bell’s palsy increases if you:
- are pregnant
- have diabetes
- have a lung infection
- have a family history of the condition
Bell’s Palsy diagnosis
Your doctor will first perform a physical examination to determine the extent of the weakness in your facial muscles. They’ll also ask you questions about your symptoms, including when they occurred or when you first noticed them.
Your doctor can also use a variety of tests to make a Bell’s palsy diagnosis. These tests may include blood tests to check for the presence of a bacterial or viral infection. Your doctor might also use an MRI or CT scan to check the nerves in your face.
Bell’s Palsy Treatment
In most cases, Bell’s palsy symptoms improve without treatment. However, it can take several weeks or months for the muscles in your face to regain their normal strength.
The following treatments may help in your recovery.
- corticosteroid drugs, which reduce inflammation
- antiviral or antibacterial medication, which may be prescribed if a virus or bacteria caused your Bell’s palsy
- over-the-counter pain medications, such as ibuprofen or acetaminophen, which can help relieve mild pain
- eye drops
- an eye patch (for your dry eye)
- a warm, moist towel over your face to relieve pain
- facial massage
- physical therapy exercises to stimulate your facial muscles
Potential Complications of Bell’s Palsy
Most people who have an episode of Bell’s palsy will completely recover without complications. However, complications may occur in more severe cases of Bell’s palsy. These include the following:
- You may have damage to the seventh cranial nerve. This nerve controls your facial muscles.
- You may have excessive dryness in the eye, which can lead to eye infections, ulcers, or even blindness.
- You may have synkinesis, which is a condition in which moving one body part causes another to move involuntarily. For example, your eye may close when you smile.
When to see a doctor
Call your doctor immediately if you’re showing any signs of Bell’s palsy. Prompt treatment can help speed up your recovery time and prevent any complications.
Long-term Outlook for People with Bell’s Palsy
The outlook for people with Bell’s palsy is usually good. Recovery time may vary depending on the severity of nerve damage. In general, however, people can see an improvement within two weeks after the initial onset of symptoms. Most will completely recover within three to six months, but it may be longer for people with more severe cases of Bell’s palsy. In rare cases, symptoms may continue to return or may be permanent.