Bell's Palsy

The following discussion is for general informational purposes only and is not meant to provide the reader with specific medical advice. Please consult with your personal physician, or with a neurologist, for specific advice, guidance and information regarding your particular circumstances.


Bell's palsy is a weakness (or palsy) of the facial nerve. This weakness is likely the result of swelling of the facial nerve. Patients with this condition generally present with a droop of one side of the face resulting in problems with closing the eye and mouth on that side. Bell's palsy occurs in approximately 25 out of 100,000 people. The exact cause of Bell's palsy is not known, but in many cases a viral infection may be playing a role. In places where Lyme's disease is endemic, this condition may also be involved.


One of the earliest signs of Bell's palsy is a sharp ache behind the ear on the affected side of the face. This is followed by weakness of the mouth and eye resulting in a one sided facial droop. People also can experience changes in taste, blurry vision, changes in hearing, problems chewing and swallowing and tingling sensations in the affected half of the face. These symptoms may develop over the course of several hours or a day. The severity of the symptoms varies from person to person. Even mild cases of Bell's palsy may take many months to resolve. As a general rule, the more severe the facial weakness, the longer the recovery will be.


There is no single test to diagnose Bell's palsy. Other conditions such as injury, stroke and tumor will need to be ruled out with an imaging study such as a magnetic resonance imaging (MRI) or computerized tomography (CAT) scan. Blood work to look for conditions such as Lyme's disease, B12 deficiency and inflammatory states that may result in weakness of the facial nerve may also be ordered.


People with Bell's palsy are usually treated with a short course of steroids (such as prednisone) to decrease swelling of the nerve. An antiviral medication, such as acyclovir, may also be prescribed to help fight viral infections. If the facial weakness persists, physical therapy and massage therapy may be beneficial.