What Is Bell’s Palsy?

Bell’s palsy, also known as Bell palsy and facial nerve palsy, is a neurological disorder that causes sudden, temporary weakness or paralysis of the muscles on one side of the face, resulting in a drooping appearance. It is the most common cause of facial paralysis and thought to develop from injury to a specific nerve in the face, such as from inflammation. While it can be alarming, Bell’s palsy is usually not permanent, and most people recover fully in weeks to months.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d27415c5-01ec-469d-9ff8-caec8f14270c
Types of Bell’s Palsy Types Bell’s palsy is a type of facial nerve palsy (paralysis). It was previously — and sometimes still is — known as idiopathic facial nerve palsy, meaning it arises without an identifiable cause, though some cases have now been linked to viral infections.e60dc2a1-f33c-4a05-9b50-8e3e8e59762918601d00-8c48-465f-adb1-5bb3d4020531 Bell’s palsy is usually acute (occurs suddenly and lasts a relatively short amount of time) or recurrent (occurs again after the first episode resolves).e60dc2a1-f33c-4a05-9b50-8e3e8e597629a6c75de4-ecaf-49e4-b7e2-fe706fd25c21
Signs and Symptoms of Bell’s Palsy Symptoms Bell’s palsy symptoms typically appear suddenly and may include: Muscle weakness or paralysis on only one side of the face Drooping of the mouth and eyebrow Inability or difficulty closing the eye (including blinking and squinting), which may result in excessive tearing or dryness Inability or difficulty smiling on the affected side Drooling from the affected side of mouthe60dc2a1-f33c-4a05-9b50-8e3e8e59762987b144ee-7e57-4988-8d59-5ad9ac10e7d0 Headachee60dc2a1-f33c-4a05-9b50-8e3e8e597629fa00edfa-88aa-4420-a138-ee1774ff70de Loss of taste on the front two-thirds of the tongue Heightened sensitivity to sound in one ear (hyperacusis) Pain in or behind the affected eare60dc2a1-f33c-4a05-9b50-8e3e8e59762953ca81bc-79ef-4063-aec2-dc95ff05df94 Neck paine60dc2a1-f33c-4a05-9b50-8e3e8e597629f85826da-5dbd-4748-acca-1fd3a1eb4b27 Tinnitus, or ringing in the earse60dc2a1-f33c-4a05-9b50-8e3e8e597629b184e825-b222-482c-beca-0ea459ae71ac Symptoms typically worsen over 48 to 72 hours after they begin, before gradually improving.e60dc2a1-f33c-4a05-9b50-8e3e8e59762919ae5ba2-c0c7-4f77-935e-3c9156dc3ef5
Causes and Risk Factors of Bell’s Palsy Causes While its exact cause is unknown, Bell’s palsy is thought to be linked to injury or dysfunction of the facial nerve. Also known as the seventh cranial nerve, the facial nerve controls muscles in the face and plays a role in the tear and saliva glands, sensations in the ear, and more.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c6ffcb8b-5183-4ab8-9e92-b1ce034e1984 This facial nerve dysfunction may be due to inflammation caused by a viral infection, most commonly herpes simplex virus , which causes cold sores.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fede6864-35d4-435e-aedc-f10406c5d964 Other potential triggers include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e0fc7372-6a72-40ea-8978-1f8a118335de Epstein-Barr virus Varicella-zoster virus, which causes shingles and chickenpox Coxsackievirus Cytomegalovirus Mumps virus SARS-CoV-2 virus Rubella virus Influenza viruses Risk factors for Bell’s palsy include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976299d434088-8268-46ae-a294-906e11248bc2 Pregnancy Severe preeclampsia (dangerously high blood pressure during pregnancy) Diabetes Hypertension Obesity Upper respiratory tract infections Family history of Bell’s palsy Lowered immunity such as from stress, illness, or lack of sleepe60dc2a1-f33c-4a05-9b50-8e3e8e5976292be5ab2c-62a2-4a28-93ee-a1c8c9ca7255 Traumatic injury to the face or heade60dc2a1-f33c-4a05-9b50-8e3e8e597629fede6864-35d4-435e-aedc-f10406c5d964
How Is Bell’s Palsy Diagnosed? Diagnosis There is no specific test for Bell’s palsy. Instead, healthcare providers diagnose the condition based on your symptoms and by ruling out other potential causes of facial paralysis, such as brain tumors, stroke, and Lyme disease .e60dc2a1-f33c-4a05-9b50-8e3e8e5976298536bedc-1875-464b-bcea-094e6a190e18 Your provider will ask you about your medical and family history to identify your symptoms and when they began, recent infections that could cause your symptoms, and risk factors you may have. They will also conduct a thorough physical examination to assess your facial muscle function, such as how your facial muscles respond when you try to make different expressions or close your eyelids. Laboratory or imaging tests are usually not necessary to diagnose Bell’s palsy, but your provider may order them to help confirm a diagnosis, rule out other potential causes of your issues, or determine how serious the disorder is and your chances of recovery. These may include:e60dc2a1-f33c-4a05-9b50-8e3e8e59762981ee62c5-6ed5-4a4f-ad62-bcbfec37a7fd Electromyography to assess your nerve functione60dc2a1-f33c-4a05-9b50-8e3e8e597629588f0940-ffd1-4003-bafa-ce0b7dcf4175 Lumbar puncture to check for meningitis Computerized tomography (CT) and magnetic resonance imaging (MRI) scans to rule out other conditions that cause nerve damage such as stroke and multiple sclerosis Blood tests to check for conditions like Lyme disease and sarcoidosis e60dc2a1-f33c-4a05-9b50-8e3e8e59762985ff92e9-a1d4-4b48-a8b7-5ee745596841
Treatment and Medication Options for Bell’s Palsy Treatment Bell’s palsy usually resolves on its own over time, and treatment focuses on reducing inflammation and supporting recovery. This may include: Corticosteroids, such as prednisone, which help reduce swelling of the nerve and possibly improve recovery speed, especially when started within 72 hours of symptom onset Antiviral medications, which are sometimes prescribed alongside steroids, though it’s unclear how much they actually help improve recoverye60dc2a1-f33c-4a05-9b50-8e3e8e597629c4923f26-84c1-43a9-9f1d-0c90f880cd80 Pain medications including ibuprofen, aspirin, and acetaminophen, as needed to control pain Lubricating eye drops, ointments, or an eye patch to keep the eye moist and protect the cornea from damage Physical therapy, facial massage, and acupuncture to help improve facial function and reduce paine60dc2a1-f33c-4a05-9b50-8e3e8e59762997f66b1d-152d-49a4-af86-bf7e8a3c339e If your symptoms don’t resolve on their own, you may need long-term treatment with physical therapy, Botox injections, or various types of surgery.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299e239ec9-c5c0-4b11-85a7-e395e03fb111e60dc2a1-f33c-4a05-9b50-8e3e8e5976299cdb708b-2409-4a93-9867-b4311f8af2d3 In some cases, facial nerve transplantation via surgery is an option.e60dc2a1-f33c-4a05-9b50-8e3e8e59762914fd42b3-2191-4238-8f49-a52a36f1b5ad
Prevention of Bell’s Palsy Prevention There is no guaranteed way to prevent Bell’s palsy. The best way to reduce your risk of developing Bell’s palsy is to reduce your risk factors, such as by: Managing chronic conditions like diabetes and hypertension Staying up to date with vaccinations Avoiding exposure to viral infections Reducing stress through mindfulness meditation , relaxation exercises, positive self-talk, and other techniquese60dc2a1-f33c-4a05-9b50-8e3e8e59762960997b66-1306-4e4a-9b5e-293c7bcd7173
Lifestyle Changes for Bell’s Palsy Lifestyle Changes Bell’s palsy typically resolves on its own over time, but supportive habits may help you find relief, including: Lubricating eye drops to prevent dryness Heat pads and warm compresses to relax the muscles in the facee60dc2a1-f33c-4a05-9b50-8e3e8e5976293d0e3c2e-1355-4efc-bf5d-f79caf5c88c0 Facial exercises (such as repeatedly tightening and relaxing your facial muscles), massage, and electrical stimulation to improve facial muscle strength and prevent long-term weaknesse60dc2a1-f33c-4a05-9b50-8e3e8e59762960a25ea0-a502-404c-8f97-b3a0ff78b53e Eating more slowly to prevent swallowing problemse60dc2a1-f33c-4a05-9b50-8e3e8e59762930b6e55f-8aff-42bd-a402-eb907e439055 Brushing and flossing often to remove food that may get stuck and cause issues (if Bell’s palsy affects feeling and salivation on the side of your tongue)
How Long Does Bell’s Palsy Last? Duration About 80 percent of people with Bell’s palsy begin to improve within three weeks and show little-to-no signs of symptoms within three months. But some people may take up to a year to recover.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290d51cb47-a35e-45de-89c6-da61d51d456fe60dc2a1-f33c-4a05-9b50-8e3e8e59762975253653-c714-4bef-a080-f187bfa86d64 However, about 2 in 10 people with Bell’s palsy don’t fully recover and have symptoms that never go away. You are less likely to recover completely if you: Experienced severe or “complete” facial paralysis Are 60 years or older Have decreased salivation or taste from Bell’s palsy Are pregnant Have diabetes Have had dental work done recently Additionally, the longer it takes for your recovery to begin and the slower your recovery occurs, the more likely you are to have lasting symptoms.
Complications of Bell’s Palsy Complications Though usually temporary, some people experience complications, such as: Residual facial weakness Involuntary facial movements (synkinesis) Damage to the cornea from prolonged drynesse60dc2a1-f33c-4a05-9b50-8e3e8e597629eb07f581-b002-4f11-a6e9-54c67caa57bf Emotional distress or self-consciousness
Research and Statistics: Who Has Bell’s Palsy? Research and Statistics Bell’s palsy affects 15 to 40 individuals per 100,000 people annually. It affects people of all ages, sexes, and ethnicities. About 8 to 12 percent of people who experience Bell’s palsy have a recurrent episode, which can develop years later.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298678d683-a485-4c7f-9214-be5774e89133
Related Conditions Related Conditions Several other conditions can cause partial or complete facial paralysis that may be confused with Bell’s palsy, particularly: Stroke Ramsay Hunt syndrome , a complication of a varicella-zoster virus infection Lyme disease Sarcoidosis, an inflammatory autoimmune diseasee60dc2a1-f33c-4a05-9b50-8e3e8e59762963fc2e86-8243-4719-83b7-bcb2f9505494
The Takeaway Bell’s palsy is a sudden, temporary facial paralysis that usually resolves on its own within a few months. It’s often associated with inflammation of the facial nerve caused by a viral infection, particularly herpes simplex virus. Early treatment with steroids can improve your chances of a full recovery.
Resources We Trust Cleveland Clinic: Bell’s Palsy: How to Recover From This Puzzling Facial Paralysis Mayo Clinic: Signs and Symptoms of Bell’s Palsy American Academy of Ophthalmology: What Is Bell’s Palsy? National Institute of Neurological Disorders and Stroke: Bell’s Palsy Johns Hopkins Medicine: Bell’s Palsy