What Is Bell’s Palsy?
Bell’s palsy is a temporary weakness or paralysis of the muscles on one side of the face. These muscles are controlled by the facial nerves.
There are two facial nerves, one on each side of the face. Bell’s palsy usually affects just one nerve, so people who have it often notice stiffness or weakness on one side of the face.
When facial nerves are working properly, they carry messages from the brain to the face. These messages may tell an eyelid to close, one side of the mouth to smile or frown, or salivary glands to make spit. Facial nerves also help our bodies make tears and taste food.
With Bell’s palsy, an immune system reaction in the body causes a facial nerve to swell. The swollen nerve gets pinched where it goes through a narrow tube of bone at the base of the skull. When the nerve is pinched and swollen like this, the brain’s messages don’t get sent correctly. That’s what causes weakness or temporary paralysis on one side of the face. When the swelling and pinching go away, the face usually returns to normal.
What Causes It?
Bell’s palsy can happen when someone has a viral infection like herpes (the virus that causes cold sores), Epstein-Barr (the virus that causes mono), or the flu. Someone who is infected with Lyme disease also can develop Bell’s palsy. Of course, this doesn’t mean that everyone who has a viral infection or Lyme disease will get Bell’s palsy — most people don’t.
Bell’s palsy usually affects adults, but it can sometimes happen to kids or teens. Pregnant women and people with diabetes are more likely to develop Bell’s palsy.
What Are the Signs?
Bell’s palsy usually shows up about 1 to 2 weeks after a viral infection. It tends to come on quickly and often reaches its worst point within 48 hours.
A few hours or days before Bell’s palsy develops fully, some people may have a headache or feel pain behind or in front of their ears. One side of the face might droop or feel stiff. Some people may only notice a slight weakness, while others might not be able to move that side of their face at all.
Other signs of Bell’s palsy include:
- difficulty closing one eye all the way
- dryness in one eye
- trouble tasting at the front of the tongue on the affected side
- changes in the amount of saliva or drooling
- hearing sounds that seem louder than usual in one ear
Bell’s palsy affects only the face. If a person has weakness or paralysis in other parts of the body, the problem has another cause.
How Is It Diagnosed?
If you start noticing signs of Bell’s palsy, see a doctor as soon as possible — especially if you’ve had an infection.
The doctor will examine you and ask questions. The doctor will want to know how long it took for your symptoms to show up, if you were sick or injured before they came on, and if you have other problems like weakness in other parts of your body.
Some other conditions can cause paralysis that’s more serious than Bell’s palsy. Tell the doctor if you are having problems like double vision or trouble swallowing. Let the doctor know if you recently hit your head. Telling your doctor as quickly as possible can help stop things from getting worse.
There’s no specific test for Bell’s palsy. A doctor may test for Lyme disease, herpes virus (HSV), or other infection. Infections like Lyme can be treated. But most of the time, the virus has already gone away.
A doctor may order imaging tests like an X-ray, CT scan, or MRI to be sure it’s Bell’s palsy and not something else. Some doctors may do an electromyography (EMG), which tests nerve strength and how well the muscles respond to nerve signals.
How Is It Treated?
When someone has Bell’s palsy, the nerve needs to renew itself. That can only happen with time — and taking good care of yourself. Sometimes doctors might prescribe medicine to reduce swelling.
If someone with Bell’s palsy can’t close an eye completely, the doctor may prescribe eye drops, an eye patch, and protective glasses. These help the patient feel more comfortable and prevent damage to the cornea.
Although Bell’s palsy can seem frightening at first, most people are back to normal in 1 to 3 months. A few people are left with some permanent facial weakness after recovering from Bell’s palsy, though.
Taking Care of Yourself
Good nutrition and rest help the body heal. If you have Bell’s palsy, eat well and get lots of sleep.
One of the hardest things about having Bell’s palsy can be dealing with the feelings that go with it. To begin with, Bell’s palsy can be just plain scary. Because it affects how your face looks for a while, you may feel self-conscious or embarrassed.
Sometimes, close friends or family may tease you because they don’t understand how you feel. If comments ever feel hurtful, speak up. Let people know why your face looks the way it does. Bell’s palsy isn’t contagious, so no one can catch it from you. Nothing you or anyone else did caused it to happen.
Dealing with a condition like Bell’s palsy often helps you find out who your real friends are. Rely on the people you know can offer you the best support — your closest friends, family, or a school counselor, for example. Within a couple of months, you should be back to your old self.
Reviewed by: Rupal Christine Gupta, MD
Date reviewed: March 2015