Bell's palsy is a sudden weakness and paralysis on one side of the face. It occurs in approximately 40,000 Americans each year and affects men and women equally.
Bell's Palsy: Facial Droop
2009 Nucleus Medical Art, Inc.
The cause of Bell's palsy is unknown. It is suspected that an irritated facial nerve becomes swollen. As the facial nerve passes through narrow openings in the skull, it is compressed and symptoms result.
Doctors believe a herpes virus may cause the nerve to become inflamed, and, in turn, cause Bell’s palsy.
may also be a cause.
Tear test—measures the eye's ability to produce tears
—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,
, or other problem in the area of the facial nerve
—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
In most cases, symptoms go away within a few weeks without treatment. Many cases of Bell's palsy completely resolve after a few months.
Protecting the eye is important because people with Bell’s palsy may not be able to blink. If an underlying cause of the symptoms is known, it is treated. For some patients, however, symptoms may never go away.
Below are several ways to treat Bell's palsy:
Corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs) reduce inflammation and pain. The antiviral medication
(Valtrex) is also prescribed for this condition.
Research has shown that steroids, such as prednisolone, can significantly improve the chance of complete recovery from Bell's palsy.
Antiviral medications, such as
(Zovirax), are also used to treat this condition.
Some doctors try to surgically relieve pressure on the nerve by removing part of the bone. This is an unproven procedure that is considered controversial and is no longer commonly performed. If the eyelid will not close, other surgeries around the eye may be considered.
Patients may need to apply lubricant or put drops in the eye. The eye can be covered and taped closed at night. Do not place tape directly on the eyelid. An eye patch may be worn to keep the eye closed. This helps moisten and keep particles out of the eye. Massage of the weakened facial muscles may be beneficial.
Most patients who do not recover are distressed by their symptoms. They may need help dealing with the emotional issues associated with the condition.
Physical therapy and speech therapy may be of value in improving symptoms.
If you are diagnosed with Bell's palsy, follow your doctor's
There are no guidelines for preventing Bell's palsy because the cause is unknown. There are no tests to detect it before symptoms begin. If you think you are at risk for Bell's palsy, talk to your doctor about ways to reduce your risk.
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New concepts in Bell's Palsy improve treatment options.
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*¹11/6/2007 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Sullivan FM, Swan IR, Donnan PT, Morrison JM, Smith BH, McKinstry B, et al. Early treatment with prednisolone or acyclovir in Bell's palsy.
N Engl J Med
*²1/6/2009 DynaMed's Systematic Literature Surveillance
DynaMed's Systematic Literature Surveillance
: Engstrom M, Berg T, Stjernquist-Desatnik A, et al. Prednisolone and valaciclovir in Bell's palsy: a randomised, double-blind, placebo-controlled, multicentre trial.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a