Bell’s palsy, or facial palsy, is a paralysis or severe weakness of the facial muscles on one side of the face, causing it to droop or become stiff. It can appear in the space of a few hours and usually resolves without treatment after some weeks or months.
As well as paralysis on one side of the face, a person
It can be worrying, but most people make a full recovery.
Bell’s palsy involves a weakness or paralysis on one side of the face, often without a clear cause.
Symptoms tend to appear over several hours. The affected side of the face tends to droop. There may also be changes in saliva and tear production and the sense of taste.
Many people fear they are having a stroke, but if the weakness or paralysis only affects the face, it is more likely to be Bell’s palsy.
In the United States, there are about
A person who develops Bell’s palsy
- sudden paralysis or weakness on one side of the face
- difficulty closing the eye, lip, or both on the affected side
- exposure of the cornea
- irritation in the eye, because it does not blink and becomes too dry
- changes in the amount of tears the eye produces
- drooping in parts of the face, such as one side of the mouth
- drooling from one side of the mouth
- a drooping brow
- change in facial expressions
- change in the sense of taste
- sensitivity to sound
unusual sensationsin the face
- facial pain
The severity of symptoms can range from mild weakness to complete paralysis.
Research shows that symptoms tend to appear and progress over
Is it a stroke or Bell’s palsy?
Someone should seek immediate medical attention if, in addition to facial drooping, a person:
- has difficulty speaking, for example, with slurred speech
- cannot raise both arms and keep them raised
- suddenly develops weakness on one side of the body
These may be signs of a stroke.
Bell’s palsy results from compression in the seventh cranial nerve, most likely due to inflammation. The seventh cranial nerve, also called the facial nerve,
There is one on each side of the face, and they:
- help control facial expressions, such as smiling and frowning
- play a role in some jaw movements
- control some muscles affecting the middle ear
- stimulate glands that produce tears and saliva
Inflammation can cause compression on the nerve as it passes through the facial canal, a location near the temple where the nerve passes through the bony skull. This compression can affect the signals that travel from the brain to the facial muscles. This leads to the weakening or paralysis of facial muscles typical of Bell’s palsy.
Often, there is no clear reason why Bell’s palsy happens, but seventh facial nerve palsy is also linked to:
If tests show that one of these is present, a doctor will treat the underlying cause.
Bell’s palsy risk factors
Conditions and factors that may increase the risk of developing Bell’s palsy
- high blood pressure
- preeclampsia, which can lead to high blood pressure during pregnancy
- being middle aged or an older adult, but with an average age of 40 years
A 2019 study concludes that people with migraine may have a higher risk of Bell’s palsy, especially if they are between the ages of
Treatment options for Bell’s palsy include:
- corticosteroids, such as prednisolone
- eye drops and ointment to manage dry eye
- surgical tape to keep the eye closed at night
- antiviral medication
In some cases, a doctor may prescribe an antiviral drug, such as acyclovir, alongside corticosteroids, but it is not clear whether they are effective.
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However, it is essential to apply this treatment accurately, or it may result in reduced function and an increased appearance of paralysis.
Anyone interested in this treatment should ask a doctor for advice and to recommend a qualified and experienced practitioner. An individualized treatment plan will be necessary, depending on how Bell’s palsy affects the person.
If Bell’s palsy prevents a person from blinking or closing their eye fully, they may develop dry eye. Changes in tear production may worsen this. A person with dry eye has a higher risk of damage or infection in the eye.
Strategies that may help reduce this risk include using:
- eye ointment
- eye drops
- tape to cover the eye while sleeping
moisture-retaining eye shield
Anyone who experiences worsening eye symptoms or signs of an infection should seek medical help immediately.
Care at home
The following may also be helpful for a person with Bell’s palsy:
- Facial exercises can help strengthen facial muscles and improve facial coordination.
- One should carefully brush and floss their teeth and attend regular dental checkups, as food particles can build up, as well as other problems can develop, due to a lack of sensation in the mouth.
- To help with swallowing, a person should chew foods well and eat slowly.
- Over-the-counter pain relief medication can help reduce discomfort.
If a person does not see an improvement within a few weeks or months, surgery may be necessary.
Surgery can help:
- prevent dry eyes
- improve facial appearance
- reduce pressure on the nerve
However, surgery to improve the appearance is
A physical therapist will recommend exercises suitable for each stage of recovery, and it is essential to follow their advice. However, below is a sample exercise plan:
- To prepare, consciously practice relaxing the unaffected side of the face.
- Gently stroke the affected side upward toward the cheekbone.
- Progress to massaging the affected area.
- Lift the eyebrow on the affected side with help from an index or middle finger.
- Gently close the eye on the same side, using a finger to help.
- Using one finger to help, gently push the side of the mouth toward the middle.
- Again, using one finger, gently pull the mouth into a smile.
- Practice for 2–3 minutes four or five times per day.
A person with Bell’s palsy may benefit from treatment starting within 72 hours of symptoms appearing, so it is best to seek medical help as soon as possible.
- will ask about symptoms
will examinethe person for upper and lower facial weakness
- will assess the facial muscles
- will review the person’s medical history
- may use electromyography to measure activity in the nerves and muscles
- may do an MRI or a CT scan to look for inflammation or other possible causes of the facial paralysis
- may do tests to rule out other conditions, such as Lyme disease
Since the COVID-19 vaccination program began in December 2020, some research has suggested that the number of cases of Bell’s palsy has risen, specifically in those who received the CoronaVac (Sinovac Biotech) vaccine, which uses an inactivated virus.
Individuals who do not see an improvement after 3 weeks should return to the doctor. The doctor may recommend a different treatment approach.
Bell’s palsy is rare in children and usually resolves without treatment.
Most people with Bell’s palsy make a full recovery. However, if damage to the facial nerve is severe, some complications are possible:
- unusual regrowthof nerve fibers, resulting in involuntary contractions of some muscles, such as closing one eye when trying to smile
- corneal dryness, increasing the risk of infection and vision loss
- permanent damage to the facial nerve
Bell’s palsy is a type of facial palsy. It results from inflammation in the seventh cranial nerve, also known as the facial nerve, and can lead to weakness or paralysis on one side of the face. In
Symptoms develop over several hours or days and peak around 72 hours.
Treatment includes steroids, possibly with antiviral medication, and treatment to prevent dry eyes. Sometimes, surgery may be necessary. A physical therapist will likely recommend some facial exercises.
Most people make a full recovery, but this may take months or weeks.