Bell’s Palsy

Written by April Khan and Marijane Leonard | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

Overview

Bell’s palsy is a condition that affects movement of the muscles in the face. The muscles are affected by damage to the seventh cranial nerve controlling them. Significant damage of this nerve can result in paralysis of the face. Swelling or inflammation of this nerve can also cause Bell’s palsy. Although the condition can affect people of any age, it is seen more in people between the ages of 16 and 60. Bell’s palsy is named after the Scottish anatomist Charles Bell, who was the first to describe the condition.

Recognizing the Signs & Symptoms of Bell’s Palsy

Symptom of Bell’s palsy may appear following a cold, ear infection, or eye infection. The symptoms usually appear rapidly, and you might notice them upon waking or when trying 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:

  • drooling
  • difficulty eating and drinking
  • inability to make facial expressions such as smiling or frowning
  • facial weakness
  • muscle twitches in the face
  • dry eye and mouth
  • headache
  • sensitivity to sound

If you develop any of the symptoms of Bell’s palsy, seek medical attention immediately. Never self-diagnose Bell’s palsy, as the symptoms can mimic other conditions such as stroke, Lyme disease, and cranial tumor.

What Causes Bell’s Palsy?

Although Bell’s palsy affects the seventh cranial nerve, experts are not sure why this happens. Many think that a viral infection is the most likely cause of the condition.

The following conditions might play a role in the development of Bell’s palsy:

  • herpes simplex, which causes cold sores and genital herpes
  • HIV
  • middle ear infection
  • Lyme disease
  • sarcoidosis
  • herpes zoster virus, which causes chickenpox and shingles
  • Epstein-Barr virus, which causes mononucleosis
  • cytomegalovirus

Testing For and Diagnosing Bell’s Palsy

Your physician will use a variety of tests to determine whether you have Bell’s palsy. He or she will order blood tests to check for the presence of a bacterial or viral infection. Your doctor might also use magnetic resonance imaging (MRI) or a computed tomography (CT) scan to check the nerves in your face. He or she will also ask you questions about when your symptoms were first noticed in addition to giving you a physical examination to see the extent of the weakness in your facial muscles.

Treatment Options for Bell’s Palsy

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 following an episode of Bell’s palsy.

The following treatments may aid in your recovery.

Medication

  • corticosteroid drugs, which reduce inflammation
  • antiviral medication, if a virus is the cause
  • over-the-counter pain medication such as ibuprofen or acetaminophen for mild pain

Home Treatment

  • using eye drops and an eye patch (for dry eye)
  • placing a warm, moist towel over your face to relieve pain,
  • massaging your face
  • doing physical therapy exercises to stimulate your facial muscles

Risk Factors for Bell’s Palsy

Your risk for developing Bell’s palsy increases if you have diabetes, are pregnant, have a lung infection, or have a genetic predisposition to it.

Long-Term Complications of Bell’s Palsy

Complications of Bell’s palsy include:

  • excessive drying of the eye, which can lead to the development of eye infections, ulcers, or even blindness
  • untreatable damage to the cranial nerve
  • synkinesis, a condition in which moving one body part causes another to move involuntarily. For example, when you smile, your eye may close.

Can You Prevent Bell’s Palsy?

There are no known ways to prevent the development of Bell’s palsy.

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