Bell's Palsy Symptoms & Diagnosis

Symptoms

Bell's palsy symptoms may come on suddenly or develop over a few days. Initial symptoms may include:

• Pain behind the ear that precedes the weakness and paralysis
• Ringing sound in the ears
• Slight fever
• Slight hearing impairment
• Slight increase in sensitivity to sound on the affected side.

Symptoms of full-blown Bell's palsy may include:

• Facial weakness or paralysis:
  • Usually on one side
  • Forehead is smooth
  • Not able to smile
• Numbness just before the weakness starts
• Drooping corner of the mouth
• Drooling
• Decreased tearing
• Inability to close an eye, which can lead to:
  • The eye becoming red and dry
  • Ulcers forming on the cornea
  • Infection
  • Possible loss of the eye
• Impaired taste
• Sound sensitivity in one ear
• Earache
• Slurred speech

Late complications (occurring 3-4 months after onset) can include:

• Contracture of the facial muscles
• Tearing from eye during eating

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam.

Other tests may include:

• Hearing test—to see if nerve damage involves the hearing nerve, inner ear, or hearing mechanism
• Balance test—to see if balance nerves are involved
• Lumbar puncture —to rule out meningitis , autoimmune disorders, or metastasis from a tumor
• Tear test—measures the eye's ability to produce tears
• CT scan —a type of x-ray that uses a computer to make pictures of structures inside the head; to see if there is an infection, tumor, bone fracture , or other problem in the area of the facial nerve
• MRI scan —a test that uses magnetic waves to make pictures of structures inside the head; to see if there is an infection, tumor, bone fracture, or other problem in the area of the facial nerve
• Electrical test—to determine damage to the facial nerve
• Blood tests—to check for diabetes, HIV infection, or Lyme disease