Bell's palsy is the common name for a condition in which paralysis strikes the seventh cranial nerve, which controls much of the face. Only one side of the face is affected. Symptoms usually come on suddenly and painlessly, and are first noticed as a droop in one corner of the mouth and an inability to smile properly. Other symptoms may include drooling, an inability to close the eye on the same side, tearing, impairment of taste, and occasionally pain. While anyone can develop Bell's palsy, it occurs most often in pregnant women and people who have diabetes, hypertension, or a respiratory infection.
Conventional treatment for Bell's palsy currently involves corticosteroid drugs (such as prednisone) and sometimes the anti-viral drug acyclovir. However, according to a review published in 2002, there is no reliable evidence that either treatment provides any benefit.1,2 A study published subsequent to the review did show a slight benefit with early, high-dose corticosteroid treatment.3
Useful supportive measures for Bell's palsy include patching the affected eye at night and using artificial tears. Surgery or electrical stimulation of the nerve are used rarely.
Note: Medical evaluation is essential because, in rare cases, Bell's palsy may be caused by an underlying condition that requires specific treatment, such as a tumor.
Hyperbaric oxygen therapy involves breathing 100% oxygen at increased pressure. It is used both by conventional and alternative practitioners. A placebo-controlled study found hyperbaric oxygen more effective than prednisone.4 In this trial, a total of 79 people with Bell's palsy were randomly assigned to receive either hyperbaric oxygen (1 hour twice daily, 5 days a week, for 30 sessions or up to full recovery) or prednisone. Placebo pills were given along with hyperbaric therapy, and fake hyperbaric therapy was given along with prednisone. The results showed a significantly greater speed of recovery as well as a higher percentage of full recovery in the hyperbaric oxygen group compared to the prednisone group.
Many alternative practitioners recommend the use of injected vitamin B12 for Bell's palsy. However, the only scientific support for this approach comes from one study that was not double-blind.5 (For information on the importance of a double-blind design, see Why Does This Database Rely on Double-blind Studies?)
Acupuncture has also been studied as a treatment for Bell's palsy. A Chinese study found that acupuncture plus moxibustion (a type of Traditional Chinese Medicine therapy) was more effective for Bell's palsy than drug treatment.6 But, researchers who did a systematic review that included 6 studies with 537 people were unable to draw any conclusions about the effectiveness of acupuncture for Bell's palsy due to poor study quality.7 In another review of 10 randomized trials of 975 patients, acupuncture alone or with drug therapy was associated with symptom improvement compared to drug therapy alone. For the same reasons as the previous review, it is not clear if acupuncture is an effective treatment.8
Biofeedback is also sometimes recommended for Bell's palsy, but there is inadequate supporting evidence.
1. Salinas RA, Alvarez G, Alvarez MI, et al. Corticosteroids for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2002;(1):CD001942.
2. Sipe J, Dunn L. Aciclovir for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev. 2001;(4):CD001869.
3. Lagalla G, Logullo F, Di Bella P, et al. Influence of early high-dose steroid treatments on Bell's palsy evolution. Neurol Sci. 2002;23:107–112.
4. Racic G, Denoble PJ, Sprem N, et al. Hyperbaric oxygen as a therapy of Bell's palsy. Undersea Hyperb Med. 1997;24:35–38.
5. Jalaludin MA. Methylcobalamin treatment of Bell's palsy. Methods Find Exp Clin Pharmacol. 1995;17:539–544.
6. Li Y, Liang FR, Yu SG, et al. Efficacy of acupuncture and moxibustion in treating Bell's palsy: a multicenter randomized controlled trial in China. Chin Med J (Engl). 2004;117:1502-1506.
7. Chen N, Zhou M, et al. Acupuncture for Bell's palsy. Cochrane Database Syst Rev. 2010;(8):CD002914.
8. Kim JI, Lee MS, et al. Acupuncture for Bell's palsy: a systematic review and meta-analysis. Chin J Integr med. 2012;18(1):48-55.
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015
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