Bells Palsy

What is Bells palsy?

Bells palsy is a condition that partly or completely paralyzes the side of your face. In rare cases, both sides of your face may be affected. Bell’s palsy occurs when your facial nerve is damaged.

The facial nerve carries signals for movement and taste and other information to and from your face. When this nerve is damaged, your face can’t get these signals to and from the brain. While it may seem scary at the time, Bells palsy usually doesn’t last long.

All of the causes of Bells palsy are not known. It may occur when a virus, such as herpes or the common cold, makes the facial nerve swell. The swollen nerve presses against the bone around it. This pressure can stop the nerve from working correctly.

Symptoms

How do I know whether I have Bells palsy?

If you have Bell’s palsy, you may have some of the symptoms listed below. Usually, these symptoms affect just one side of your face.

  • Drooping or weakness that makes the face look lopsided
  • Loss of facial expression
  • Twitching
  • Trouble eating or drinking
  • Trouble speaking
  • Total or partial loss of taste
  • Ear pain
  • Sensitivity to sound
  • Inability to close your eye
  • Dry eye

Bell’s palsy symptoms appear quickly, usually reaching their worst in a couple of days. If you have any of these symptoms, talk to your doctor. He or she can tell you whether or not you have Bell’s palsy.

Causes & Risk Factors

Who is at risk for Bell’s palsy?

While the causes of Bell’s palsy are not fully known, you may be more likely to get it if you are pregnant, are between 15 and 60 years of age, or have one of the following:

Keep in mind that most of the time these conditions will not give you Bell’s palsy. The condition only affects about 1 in every 5,000 people.Once you have had Bell’s palsy, you have a slight chance of getting it again.

Diagnosis & Tests

How does my doctor know whether I have Bell’s palsy?

There is no specific test to identify Bell’s palsy. Your doctor will probably ask questions about your symptoms and your medical history. Facial paralysis can also be caused by a stroke, a tumor or an injury, so your doctor will check to make sure that another condition is not causing your symptoms. You may need to have additional tests, such as an X-ray or a magnetic resonance imaging (MRI) test.

Treatment

How is Bell’s palsy treated?

Bell’s palsy often goes away on its own within 1 or 2 months. Your chances of full recovery will be improved if you take a prescribed course (usually for 10 days) of steroid medication, usually for 10 days, that is started as early as possible.

At home, you can take simple steps to help your recovery. Remember to eat well and get plenty of rest so you can heal. Protect your eyes with sunglasses when you are outdoors. Be careful to keep your eyes moist, especially when you are working at a computer. Using eye drops to keep your eyes moist during the day and wearing an eye patch to keep your eye closed during the night may help.

Apply low heat, such as a gel pack or heating pad, to the affected area for pain and swelling as needed. You may try gently massaging the area as well. If you are experiencing severe pain, talk to your family doctor.

Your recovery time will depend on how badly your facial nerve is damaged. If it takes a long time to improve, you may have a few lasting effects. For example, you may have facial movements you can’t control, or your eyes may water or tear.

Questions

Questions to Ask Your Doctor

  • Am I at risk of having Bell’s palsy again? If so, can I help prevent it?
  • Will this condition go away? How long will I have symptoms.
  • Are there medicines that will treat Bell’s palsy?
  • Are there exercises I can do or lifestyle changes I can make that will improve symptoms?
  • Does having Bell’s palsy signify another health condition?

Bell Palsy, Adult

Bell palsy is a short-term inability to move muscles in part of the face. The inability to move (paralysis) results from inflammation or compression of the facial nerve, which travels along the skull and under the ear to the side of the face (7th cranial nerve). This nerve is responsible for facial movements that include blinking, closing the eyes, smiling, and frowning.

What are the causes?

The exact cause of this condition is not known. It may be caused by an infection from a virus, such as the chickenpox (herpes zoster), Epstein-Barr, or mumps virus.

What increases the risk?

You are more likely to develop this condition if:

  • You are pregnant.
  • You have diabetes.
  • You have had a recent infection in your nose, throat, or airways (upper respiratory infection).
  • You have a weakened body defense system (immune system).
  • You have had a facial injury, such as a fracture.
  • You have a family history of Bell palsy.

What are the signs or symptoms?

Symptoms of this condition include:

  • Weakness on one side of the face.
  • Drooping eyelid and corner of the mouth.
  • Excessive tearing in one eye.
  • Difficulty closing the eyelid.
  • Dry eye.
  • Drooling.
  • Dry mouth.
  • Changes in taste.
  • Change in facial appearance.
  • Pain behind one ear.
  • Ringing in one or both ears.
  • Sensitivity to sound in one ear.
  • Facial twitching.
  • Headache.
  • Impaired speech.
  • Dizziness.
  • Difficulty eating or drinking.

Most of the time, only one side of the face is affected. Rarely, Bell palsy affects the whole face.

How is this diagnosed?

This condition is diagnosed based on:

  • Your symptoms.
  • Your medical history.
  • A physical exam.

You may also have to see health care providers who specialize in disorders of the nerves (neurologist) or diseases and conditions of the eye (ophthalmologist). You may have tests, such as:

  • A test to check for nerve damage (electromyogram).
  • Imaging studies, such as CT or MRI scans.
  • Blood tests.

How is this treated?

This condition affects every person differently. Sometimes symptoms go away without treatment within a couple weeks. If treatment is needed, it varies from person to person. The goal of treatment is to reduce inflammation and protect the eye from damage. Treatment for Bell palsy may include:

  • Medicines, such as:
    • Steroids to reduce swelling and inflammation.
    • Antiviral drugs.
    • Pain relievers, including aspirin, acetaminophen, or ibuprofen.
  • Eye drops or ointment to keep your eye moist.
  • Eye protection, if you cannot close your eye.
  • Exercises or massage to regain muscle strength and function (physical therapy).

Follow these instructions at home:

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If your eye is affected:
    • Keep your eye moist with eye drops or ointment as told by your health care provider.
    • Follow instructions for eye care and protection as told by your health care provider.
  • Do any physical therapy exercises as told by your health care provider.

Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have a fever.
  • Your symptoms do not get better within 2–3 weeks, or your symptoms get worse.
  • Your eye is red, irritated, or painful.
  • You have new symptoms.

Get help right away if:

  • You have weakness or numbness in a part of your body other than your face.
  • You have trouble swallowing.
  • You develop neck pain or stiffness.
  • You develop dizziness or shortness of breath.

Summary

  • Bell palsy is a short-term inability to move muscles in part of the face. The inability to move (paralysis) results from inflammation or compression of the facial nerve.
  • This condition affects every person differently. Sometimes symptoms go away without treatment within a couple weeks.
  • If treatment is needed, it varies from person to person. The goal of treatment is to reduce inflammation and protect the eye from damage.
  • Contact your health care provider if your symptoms do not get better within 2–3 weeks, or your symptoms get worse.

Bell Palsy, Pediatric

Bell palsy is a short-term inability to move muscles in part of the face. The inability to move (paralysis) results from inflammation or compression of the facial nerve, which travels along the skull and under the ear to the side of the face (7th cranial nerve). This nerve is responsible for facial movements that include blinking, closing the eyes, smiling, and frowning.

What are the causes?

The exact cause of this condition is not known. It may be caused by an infection from a virus, such as the chickenpox (herpes zoster), Epstein-Barr, or mumps virus.

What increases the risk?

This condition is more likely to develop in children who:

  • Have had a recent infection in the nose, throat, or airways (upper respiratory infection).
  • Have had recent hand-foot-and-mouth disease (coxsackie virus).
  • Have diabetes.
  • Have a weakened body defense system (immune system).
  • Have had a facial injury, such as a fracture.
  • Have a family history of Bell palsy.

What are the signs or symptoms?

Symptoms of this condition include:

  • Weakness on one side of the face.
  • Drooping eyelid and corner of the mouth.
  • Excessive tearing in one eye.
  • Difficulty closing the eyelid.
  • Dry eye.
  • Drooling.
  • Dry mouth.
  • Changes in taste.
  • Change in facial appearance.
  • Pain behind one ear.
  • Ringing in one or both ears.
  • Sensitivity to sound in one ear.
  • Facial twitching.
  • Headache.
  • Impaired speech.
  • Dizziness.
  • Difficulty eating or drinking.

Most of the time, only one side of the face is affected. Rarely, Bell palsy affects the whole face.

How is this diagnosed?

This condition is diagnosed based on:

  • Your child’s symptoms.
  • Your child’s medical history.
  • A physical exam.

Your child may also have to see health care providers who specialize in disorders of the nerves (neurologist) or diseases and conditions of the eye (ophthalmologist). Your child may have tests, such as:

  • A test to check for nerve damage (electromyogram).
  • Imaging studies, such as CT or MRI scans.
  • Blood tests.

How is this treated?

This condition affects every child differently. Sometimes symptoms go away without treatment within a couple weeks. If treatment is needed, it varies from child to child. The goal of treatment is to reduce inflammation and protect the eye from damage.

Treatment for Bell palsy may include:

  • Medicines, such as:
    • Steroids to reduce swelling and inflammation.
    • Antiviral drugs.
    • Pain relievers, including acetaminophen or ibuprofen.
  • Eye drops or ointment to keep your child’s eye moist.
  • Eye protection, if your child cannot close his or her eye.
  • Exercises or massage to regain muscle strength and function (physical therapy).

Follow these instructions at home:

  • Give your child over-the-counter and prescription medicines only as told by your child’s health care provider. Do notgive your child aspirin because of the association with Reye syndrome.
  • If your child’s eye is affected:
    • Keep your child’s eye moist with eye drops or ointment as told by your child’s health care provider.
    • Follow instructions for eye care and protection as told by your child’s health care provider.
  • Have your child do any physical therapy exercises as told by your child’s health care provider.

Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

  • Your child has a fever.
  • Your child’s symptoms do not get better within 2–3 weeks, or your child’s symptoms get worse.
  • Your child’s eye is red, irritated, or painful.
  • Your child has new symptoms.

Get help right away if:

  • Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.
  • Your child has weakness or numbness in a part of the body other than the face.
  • Your child has trouble swallowing.
  • Your child develops neck pain or stiffness.
  • Your child develops dizziness or shortness of breath.

Summary

  • Bell palsy is a short-term inability to move muscles in part of the face. The inability to move (paralysis) results from inflammation or compression of the facial nerve.
  • This condition affects every child differently. Sometimes symptoms go away without treatment within a couple weeks.
  • If treatment is needed, it varies from child to child. The goal of treatment is to reduce inflammation and protect the eye from damage.
  • Contact your child’s health care provider if your symptoms do not get better within 2–3 weeks, or your symptoms get worse.
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