The symptoms of Bell’s palsy include sudden weakness in your facial muscles. In most cases, the weakness is temporary and significantly improves over weeks. The weakness 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 acute peripheral facial palsy of unknown cause, can occur at any age. The exact cause is unknown. It’s believed to be the result of swelling and inflammation of the nerve that controls the muscles on one side of your face. Or it might 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 loss of 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.
Although the exact reason Bell’s palsy occurs isn’t clear, it’s often related to having a viral infection. Viruses that have been linked to Bell’s palsy include viruses that cause:
- Cold sores and genital herpes (herpes simplex)
- Chickenpox and shingles (herpes zoster)
- Infectious mononucleosis (Epstein-Barr)
- Cytomegalovirus infections
- Respiratory illnesses (adenovirus)
- German measles (rubella)
- Mumps (mumps virus)
- Flu (influenza B)
- Hand-foot-and-mouth disease (coxsackievirus)
A mild case of Bell’s palsy normally disappears within a month. Recovery from a more severe case involving total paralysis varies. Complications may include:
- Irreversible damage to your facial nerve.
- Abnormal regrowth of nerve fibers. This may result in involuntary contraction of certain muscles when you’re trying to move others (synkinesis) — for example, when you smile, the eye on the affected side may close.
- Partial or complete blindness of the eye that won’t close due to excessive dryness and scratching of the clear protective covering of the eye (cornea).
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 possibly beneficial for some people with Bell’s palsy, but this is still unproved.
However, despite this, valacyclovir (Valtrex) or acyclovir (Zovirax) is sometimes given in combination with prednisone in people with severe facial palsy.
At Alimran Medical Center, we may recommend any of the following treatments