With Bell’s palsy, a nerve that runs between the ear and the jaw becomes injured or stops working. This paralyzes the muscles on one side of the face. The lifetime risk of this disorder is about 1 in 60 people. It can occur at any age but most often occurs between ages 15 to 45 years. In older persons, it is especially important to distinguish Bell’s palsy from a stroke.
Signs & Symptoms
The onset of signs and symptoms is usually sudden. You may have pain or tingling on one side of your face 1 or 2 days before signs and symptoms occur. Often, symptoms will be noticed when you wake up.
These problems occur with your eye:
Your eyelid droops.
You can’t close your eye.
Your eye tears or becomes dry and irritated.
These problems occur on one side of your face:
It droops or sags, has no expression, or looks flat.
The muscles are weak or paralyzed.
You can’t smile or frown or if you can, these look distorted. You drool.
Pain. The area behind the ear on that side of your face can hurt, too.
Other problems can occur:
You have changes in taste.
You are more sensitive to noise.
Causes & Risk Factors
The cause is not known. These factors may cause the facial nerve to swell or possibly trigger symptoms to occur:
An existing dormant virus, such as herpes simplex, chickenpox, or shingles
Impaired immunity due to physical injury, minor illness, autoimmune disorders, sleep deprivation, or stress
Infection of a facial nerve and inflammation from Lyme disease
Damage to the myelin sheath, which is the fatty covering that insulates nerve fibers
Family traits
Most of the time, Bell’s palsy goes away on its own. If you have symptoms, though, you should see your doctor. They can make the diagnosis and rule out other conditions, such as a stroke. The time it takes to recover varies and depends on the extent of nerve damage and how severe the paralysis is.
Even 80% to 90% of persons with severe facial paralysis have a complete recovery. Symptoms start to go away in about 2 to 3 weeks. It could take months for them to be all gone.
Self-Care
Try to be patient. Bell’s palsy is a cause for distress, but is not dangerous. The goal of self-care is to ease symptoms and to prevent damage to the eye.
For Pain:
Take an over-the-counter medicine for pain.
Cover or close your eye. Apply a heating pad (set on low) to the painful area. Do this for 15 minutes at a time, 2 times a day.
Soak a washcloth in hot water. Wring it out. Close your eye and place it on the closed eye for 15 minutes.
If You Cannot Close Your Eye:
Wear wraparound goggles during the day to protect your eyes from dust, dirt, and dryness. Wear an eye patch at night to help hold the eyelid shut.
Use over-the-counter artificial tears as advised by your doctor.
Keep up with your normal activities.
Eat soft foods, if you need to.
Self-care can help with the discomfort. For severe cases, a doctor may prescribe:
Physical and/or speech therapy
Corticosteroid medicine to reduce swelling of the affected nerve
Eye drops to comfort and protect the affected eye
Electrical stimulation to the affected muscle by a physical therapist if this is done close to the onset of symptoms
Surgery, on occasion, to reduce pressure on the facial nerve
Plastic surgery may be done in rare cases, if the face remains paralyzed.
Contact Doctor When:
You have no improvement in symptoms 3 weeks after you have been diagnosed with Bell’s palsy.
You have any of these problems after a diagnosis of Bell’s palsy:
Symptoms get worse.
The numbness or weakness appear to be spreading or affect an area or body part not affected before.
Your eye gets very red or irritated.
Fever
Severe pain
Swelling or a lump in front of the ear
Get Immediate Care When:
You have signs of a stroke.
{Note: Immediate care is advised because the initial symptoms of Bell’s palsy are similar to ones of a stroke. This is especially true for older persons.}
