Bell’s palsy is a sudden weakness (paralysis) in the muscles on one side of the face. This produces a strange, lop-sided appearance of the face. The corner of the mouth droops and the eye on the affected side may not close properly. Mostly, Bell’s palsy is temporary and the symptoms resolve over time.

Symptoms of Bell’s palsy

Always seek immediate medical advice if you have symptoms of paralysis, as you may be having a stroke.

Symptoms of Bell’s palsy may come on very suddenly over a few hours and include:

  • Weakness or paralysis on one side of the face;
  • Drooping at the corner of the mouth;
  • Drooling;
  • Difficulty eating, with food escaping your mouth;
  • Being unable to smile with that side of your face;
  • Not being able to wrinkle your forehead (this can help distinguish Bell’s palsy from a stroke – because in a stroke the forehead muscles are not affected);
  • Not being able to close one eye. It may become dry or watery;
  • Difficulty with some words; and
  • Pain behind the ear or around the jaw.

Causes

Bell’s palsy is due to a problem with the nerve supplying the face — the facial nerve. On its way from the brain to the muscles of the face the facial nerve passes through a tiny hole in the skull. Swelling of the nerve due to inflammation can cause it to get trapped in this hole, causing paralysis of the muscles it supplies. Why this should happen is uncertain but it may be due to a virus infection. Several viral infections have been linked to Bell’s palsy, including cold sore infections, chickenpox and shingles, Epstein-Barr virus, mumps, and hand, foot and mouth disease.

Who get’s Bell’s palsy?

Bell’s palsy can occur at any age, but risk increases with age. It is more common in pregnant women and people with diabetes.

Will I get better?

Bell’s palsy usually gets better on its own, but this can take several weeks. Sometimes it can take up to a year for recovery. Unfortunately, 20-30 per cent of people are left with residual weakness which may be cosmetically apparent. Older people and those with a more complete paralysis have less chance of full recovery.

Treatment

Corticosteroids, when started within 72 hours of the onset of weakness, may improve the chances of full recovery. There may be a slight added benefit from also taking an antiviral medicine at the same time as the steroid. If your eye doesn’t close properly, the eye needs to be protected from drying out and injury with eye ointment and patches.

Last Reviewed: 25/09/2015

myDr


References

1. Mayo Clinic. Bell’s palsy. Dec 2014. http://www.mayoclinic.org/diseases-conditions/bells-palsy/basics/definition/con-20020529?p=1 (accessed Sept 2015).
2. Patient. Bell’s palsy. March 2013. http://patient.info/health/bells-palsy (accessed Sept 2015).