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Bell Palsy

Definition

Bell palsy is a sudden weakness on one side of the face.

Causes

The exact cause is not known. It is thought to be a result of an infection that affects the nerve, such as the herpes simplex virus and Lyme disease.

Risk Factors

Things that may raise the risk of this health problem are:

  • Diabetes
  • Being in the third trimester of pregnancy

Symptoms

Symptoms may start all at once or get worse over 48 hours. They may be:

  • Twitching, weakness, or paralysis, most often on one side
  • Drooping corner of the mouth
  • Drooling
  • Drooping or problems closing an eye, which can cause dry eye
  • Excess tears from an eye
  • Loss of taste
  • Sensitivity to sounds
  • Pain in the jaw or ear
  • Headache
  • Dizziness

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. This is often enough to make the diagnosis. Some people may need to see a doctor who treats eyes.

Treatment

Bell palsy often gets better on its own within a few weeks. Full healing may take 3 to 6 months. The goal of treatment is to manage symptoms during this time. This can be done with:

Medication

Corticosteroids may be given to ease swelling. They may be given with anti-viral medicine to ease severe symptoms in some people.

Self-care

Eye care may be needed in some people. This may include:

  • Lubricant or eye drops
  • Covering and taping the eye closed at night
  • An eye patch to keep the eye closed

Therapy

Physical therapy may be needed. It may include facial exercises.

Prevention

There are no methods to prevent Bell palsy.

RESOURCES:

Centers for Disease Control and Prevention
http://www.cdc.gov

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:

Bell's palsy. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/bells-palsy.html. Updated October 6, 2017. Accessed October 11, 2019.

Bell's palsy. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/?q=node/1465. Updated August 2018. Accessed October 11, 2019.

Bell palsy. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/bell-palsy. Updated February 28, 2018. Accessed October 11, 2019.

Bell’s palsy information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Bells-Palsy-Information-Page. Updated March 27, 2019. Accessed October 11, 2019.

de Almeida JR, Guyatt GH, et al. Management of Bell palsy: clinical practice guideline. CMAJ. 2014 Sep 2;186(12):917-922.

Schwartz SR, Jones SL, Getchius TS, Gronseth GS. Reconciling the clinical practice guidelines on Bell’s palsy from the AA-HNSF and the AAN. Neurology. 2014;82(21):1927-1929.

Last reviewed September 2019 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 10/11/2019