Bell’s palsy

What is Bell’s palsy?

 

Bell’s palsy is sudden and unexplained muscle weakness or paralysis in the facial muscle. It can affect anyone at any age and often worsens over the course of 48 hours. Pain and discomfort is commonly felt on one side of a person’s face or head. Bell’s palsy makes half of the face appear to droop. A one-sided smile and the eye on the affected side being hard to close might suggest the condition. Bell’s palsy rarely affects nerves on both sides of the face.

 

Bell’s palsy is not considered permanent. Recovery is typically two weeks to six months from the onset of symptoms. Most individuals who experience Bell’s palsy recover their full facial strength and range of expressions. There are rare cases where there are longer lasting effects. Speak to a healthcare provider if you have concerns about your Bell’s palsy recovery process.

How common is Bell’s palsy?

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Bell’s palsy is a relatively common condition with about 1 in 60 people experiencing it at some point in their lives. About 15 to 30 people out of 100,000 develop Bell’s palsy each year.

What causes Bell’s palsy?

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Although Bell’s palsy is unexplained, the condition is a result of damage to the facial nerve. Bell’s palsy is sometimes linked to:

  • High blood pressure
  • Diabetes
  • Pregnancy
  • Lyme disease
  • Toxins
  • Guillain-Barré syndrome
  • Sarcoidosis
  • Infection (like cold sores and genital herpes)
  • Chickenpox and shingles
  • Respiratory illnesses
  • Rubella
  • COVID-19

 

There are other possible triggers for Bell’s palsy. Some causes come from having a weakened immune system due to:

  • Stress
  • Sleep deprivation
  • Autoimmune conditions
  • Physical trauma
  • Illnesses

 

Even if a healthcare provider cannot determine the specific trigger of Bell’s palsy, try to remain optimistic. That is not uncommon and a doctor will be able to give you a better idea about what you can expect to happen next.

What are the symptoms of Bell’s palsy?

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The symptoms of Bell’s palsy often occur suddenly, but there can be warning signs. A few early symptoms can include pain behind your ear or a slight fever. It is important to keep in mind that these potential symptoms are not necessarily related to Bell’s palsy. Bigger symptoms may be:

  • Headache
  • Tearing
  • Dry eyes
  • Drooling
  • An inability to close your eye on the affected side
  • Hypersensitivity to sound in the affected ear
  • Loss of taste on the front part of the tongue
  • Facial droop
  • Pain around the jaw
  • Pain in or behind your ear
  • Ringing in your ears (tinnitus)

 

The symptoms of Bell’s palsy are not exclusively indicators of the condition. It is best to see your healthcare provider or a specialist for a more thorough and accurate diagnosis.

What are the risk factors for Bell’s palsy?

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Bell’s palsy can affect men and women of any age. The condition is less common before the age of 15 or after the age of 60. People living with an increased risk of Bell’s palsy occurring:

  • Have high blood pressure
  • Have obesity
  • Have diabetes
  • Are pregnant (particularly in the third trimester)
  • Have preeclampsia
  • Are in the first week postpartum
  • Have an upper respiratory infection (like the flu or a cold)

 

Bell’s palsy rarely recurs in people who experience it. Those with a family history of repeat attacks are more prone to these recurrences. Make sure to give any healthcare provider a complete outline of your family’s medical history when possible.

How is Bell’s palsy diagnosed?

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There are currently no tests that can diagnose Bell’s palsy. Your doctor or a healthcare provider will therefore want to rule out the presence of a tumor or that you had a stroke since symptoms may be similar to Bell’s palsy.

Tests to determine the severity of the nerve damage or to rule out other conditions include:

  • Blood tests (testing for Lyme disease of sarcoidosis)
  • Electromyography (measuring nerve activity and damage)
  • MRI or CT scans (ruling out stroke, tumor, multiple sclerosis)
  • Spinal tap (checking for meningitis, Lyme disease, sarcoidosis)

 

Speak with your doctor about which tests might be appropriate for your condition and with your medical history in mind.

What is the treatment for Bell’s palsy?

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Treating Bell’s palsy differs on a case-by-case basis. If your doctor determines that an infection is the cause of Bell’s palsy, they will prescribe treatment with that in mind. Eye care is one thing that is essential so that you can protect the eye from drying at night or while using a computer.

Eye care methods to protect the cornea from being scratched include:

  • Using eye drops during the day
  • Applying ointment at bedtime
  • Using a moisture chamber at night

 

Other treatment choices that your doctor may prescribe depending on the severity of your symptoms include:

  • Antiviral medicine
  • Physical therapy to stimulate the facial nerve
  • Steroids to reduce inflammation
  • Painkillers or moist heat to relieve pain/discomfort

 

These are some alternative therapies that people choose to explore for treating Bell’s palsy:

  • Acupuncture
  • Electrical stimulation
  • Relaxation
  • Vitamin therapy (B-12, B-6, zinc)
  • Biofeedback training

 

These methods are not proven more effective than other forms of treatment. It is still worthwhile to learn about them and discuss all of your options with a healthcare provider.

What is the outlook for Bell’s palsy?

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Bell’s palsy typically resolves itself with time and patience. There are generally no long-term complications from Bell’s palsy, especially if you follow the instructions given by your doctor. Some people can still experience:

  • Lasting facial weakness
  • Abnormal uncontrolled facial movements (spasms)

Some individuals opt for surgery to address any weakness that significantly affects the eyelids. Keep in mind that up to 80% of people fully recover within three months and show no lingering signs of the condition.

How can I prevent Bell’s palsy?

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There are, unfortunately, no clear-cut ways for you to prevent Bell’s palsy. Managing certain risk factors that could predispose you for Bell’s palsy — including obesity, diabetes, and high blood pressure — could help you reduce the risk, but there are no guarantees.

When should I see a doctor about Bell’s palsy?

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Reach out to your healthcare provider immediately if you develop new or worsening symptoms. You should also call your provider if you do not improve in that initial two-week period or notice anything concerning in the following three to six months.

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