Bell’s palsy causes sudden weakness in your facial muscles. This makes half of your face appear to droop. Your smile is one-sided, and your eye on that side resists closing.
Bell’s palsy, also known as facial palsy, can occur at any age. The exact cause is unknown, but it’s believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. It may be a reaction that occurs after a viral infection.
For most people, Bell’s palsy is temporary. Symptoms usually start to improve within a few weeks, with complete recovery in about six months. A small number of people continue to have some Bell’s palsy symptoms for life. Rarely, Bell’s palsy can recur.
Signs and symptoms of Bell’s palsy come on suddenly and may include:
- Rapid onset of mild weakness to total paralysis on one side of your face — occurring within hours to days
- Facial droop and difficulty making facial expressions, such as closing your eye or smiling
- Pain around the jaw or in or behind your ear on the affected side
- Increased sensitivity to sound on the affected side
- A decrease in your ability to taste
- Changes in the amount of tears and saliva you produce
In rare cases, Bell’s palsy can affect the nerves on both sides of your face.
Bell’s palsy occurs more often in people who:
- Are pregnant, especially during the third trimester, or who are in the first week after giving birth
- Have an upper respiratory infection, such as the flu or a cold
- Have diabetes
Also, some people who have recurrent attacks of Bell’s palsy, which are rare, have a family history of recurrent attacks. In those cases, there may be a genetic predisposition to Bell’s palsy.
Treatments and drugs
Most people with Bell’s palsy recover fully — with or without treatment. There’s no one-size-fits-all treatment for Bell’s palsy, but your doctor may suggest medications or physical therapy to help speed your recovery. Surgery is rarely an option for Bell’s palsy.
Commonly used medications to treat Bell’s palsy include:
- Corticosteroids, such as prednisone, are powerful anti-inflammatory agents. If they can reduce the swelling of the facial nerve, it will fit more comfortably within the bony corridor that surrounds it. Corticosteroids may work best if they’re started within several days of when your symptoms started.
- Antiviral drugs. The role of antivirals remains unsettled. Antivirals alone have shown no benefit compared with placebo. Antivirals added to steroids are also unlikely to be beneficial.However, despite this, valacyclovir (Valtrex) is sometimes given in combination with prednisone in people with severe facial palsy.
Paralyzed muscles can shrink and shorten, causing permanent contractures. A physical therapist can teach you how to massage and exercise your facial muscles to help prevent this from occurring.
In the past, decompression surgery was used to relieve the pressure on the facial nerve by opening the bony passage that the nerve passes through. Today, decompression surgery isn’t recommended. Facial nerve injury and permanent hearing loss are possible risks associated with this surgery.
In rare cases, plastic surgery may be needed to correct lasting facial nerve problems.