Bell's palsy

Bell's palsy is a condition that causes sudden paralysis of the facial muscles. It usually affects only one side of the face, but it can also affect both sides at the same time. The paralysis is temporary and often goes away on its own within a few months. In more severe cases, recovery may be incomplete. Bell's palsy can occur at any age, but it usually affects people between the ages of 15 and 60.

Bell's palsy comes on suddenly; symptoms reach peak intensity within 48 to 72 hours. The paralyzed part of the face stays expressionless, and the corner of the mouth may droop slightly. The paralysis is often accompanied by other symptoms:

• Difficulty closing the affected eye, which may become dry
• Change in tear and saliva production
• Facial pain and numbness
• Pain in or behind the ear
• Sensitivity to noise (sounds appear louder)
• Problems with taste

Causes and triggers

Bell's palsy is triggered by inflammation of the facial nerve. This nerve controls the facial muscles, tear production, and taste. However, the exact cause of the inflammation is often not easily identified. It's possible the inflammation is brought on by a viral infection like those causing shingles, cold sores, COVID-19 or the flu.

The factors below may increase the risk of developing Bell's palsy:

• Diabetes
• High blood pressure
• Pregnancy
• Obesity
• History of Bell's palsy
• Weakened immune system

It's rare for a person to experience Bell's palsy more than once in their lifetime. However, this can happen if there is a family history of repeated episodes.

Treatment

Most people affected by Bell's palsy make a full recovery without treatment. That said, certain medicines and therapies can speed up the recovery process:

• Anti-inflammatory drugs, such as prescription corticosteroids (take within 48 to 72 hours of symptom onset for best results)
• Antiviral drugs
• Pain relievers such as ibuprofen (Advil, Motrin) and acetaminophen (Tylenol)
• Physical therapy (facial exercises and different types of massage)

It's also important to protect the affected eye from dryness and injury, as it may remain partially or fully open. It can be helpful to do the following:

• During the day, apply artificial tears and wear glasses
• At night, apply a lubricating ophthalmic ointment and wear an eye patch

When should I see a health care professional?

Consult your health care provider immediately if:

• You experience any kind of paralysis. The symptoms of Bell's palsy closely resemble those of other, more serious conditions (e.g. stroke).

Consult your health care provider if you have been diagnosed with Bell's palsy and:

• Your symptoms worsen or do not improve
• You develop other symptoms
• Your eye won't close or is constantly irritated
• You experience dizziness or hearing loss