Conditions & Treatments

Bell's Palsy

Bell's palsy is an unexplained episode of facial muscle weakness or paralysis that begins suddenly and worsens over three to five days. This condition results from damage to the 7th (facial) cranial nerve, and pain and discomfort usually occurs on one side of the face or head.

Bell's Palsy

What is Bell's palsy?

Bell's palsy is an unexplained episode of facial muscle weakness or paralysis that begins suddenly and worsens over three to five days. This condition results from damage to the 7th (facial) cranial nerve, and pain and discomfort usually occurs on one side of the face or head.

It can strike anyone at any age, but it occurs most often in pregnant women, and people who have diabetes, influenza, a cold or another upper respiratory ailment. According to the National Institute of Neurological Disorders and Stroke, this nerve disorder affects about 40,000 U.S. adults and children each year. Bell's palsy strikes men and woman equally. It is less common before age 15 or after age 60.

Bell's palsy is not considered permanent, but in rare cases it does not disappear. Currently, there is no known cure for Bell's palsy; however, recovery usually begins two weeks to six months from the onset of the symptoms. The majority of people with Bell's palsy recover full facial strength and expression.

What causes Bell's palsy?

A specific cause of Bell's palsy is unknown, however, it has been suggested that the disorder is due to inflammation that is directed by the body's immune system against the nerve controlling movement of the face. The weakness or symptoms seen in Bell's palsy is sometimes associated with the following:

  • Diabetes

  • High blood pressure

  • Trauma

  • Toxins

  • Lyme disease

  • Guillain-Barré syndrome

  • Sarcoidosis

  • Myasthenia gravis

  • Infection, especially following a viral infection with Herpes simplex virus (a virus that is related to the cause of the common "cold sores" of the mouth)

These conditions cause weakness through a different mechanism than the usual inflammation of Bell's palsy.

What are the symptoms of Bell's palsy?

Illustration of Bell's Palsy
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The following are the most common symptoms of Bell's palsy. However, each individual may experience symptoms differently. Symptoms may include:

  • Disordered movement of the muscles that control facial expressions, such as smiling, squinting, blinking, or closing the eyelid

  • Loss of feeling in the face

  • Headache

  • Tearing

  • Drooling

  • Loss of the sense of taste on the front two-thirds of the tongue

  • Hypersensitivity to sound in the affected ear

  • Inability to close the eye on the affected side of the face

The symptoms of Bell's palsy may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

What is the treatment for Bell's palsy?

One uniformly recommended treatment for Bell's palsy is protecting the eye from drying at nighttime or while working at a computer. Eye care, which may include eye drops during the day, ointment at bedtime, or a moisture chamber at night, helps to protect the cornea from scratching, which is crucial to the management of Bell's palsy.

Your doctor will establish an appropriate treatment protocol for your condition based on the severity of your symptoms and your medical profile. Other treatment options include:

  • Steroid medications to reduce inflammation

  • Antiviral medications, such as acyclovir

  • Analgesics or moist heat to relieve pain

  • Physical therapy to stimulate the facial nerve

Some individuals may choose to use alternative therapies in the treatment of Bell's palsy, but there is no proof these alternative therapies actually make an absolute difference in a person's recovery. Such treatment may include:

  • Relaxation

  • Acupuncture

  • Electrical stimulation

  • Biofeedback training

  • Vitamin therapy, including B12, B6, and the mineral zinc

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Massachusetts General Hospital understands that a variety of factors influence patients' health care decisions. That's just one reason why we're dedicated to ensuring patients understand their diagnosis and treatment options. Because a single option might not serve all patients, we offer a wide range of coordinated treatments and related services across the hospital. Patients should consult with their primary care doctor or other qualified health care provider for medical advice and diagnosis information.

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