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What is Bell’s palsy?
Bell's palsy is temporary, unexplained paralysis or muscle weakness in your face, usually on one side. Bell's palsy is most common in people between the ages of 15 and 60 who are pregnant or who have diabetes, high blood pressure, obesity or a flu or cold or other respiratory infection.
Bell’s palsy is temporary, unexplained paralysis or muscle weakness in your face, usually on one side. It comes on suddenly and gets worse over 48 to 72 hours.
Bell’s palsy happens when the 7th cranial nerve in your face becomes damaged. The nerve controls lots of muscles in your face, including muscles for:
- Blinking
- Opening and closing your eyes
- Smiling
- Part of the inner ear
The 7th nerve also sends signals to your tear and saliva glands, and taste signals to your tongue. When the nerve is damaged, your muscles and glands won’t receive signals, which leads to problems.
What causes Bell’s palsy?
It’s not clear what causes Bell’s palsy. Some people have an inherited tendency to Bell’s palsy, but in most cases, it’s likely caused by viral infections that damage your nerves, a low immune system, or an immune system disorder. Immune problems can happen from:
- Stress
- Minor illness
- Autoimmune disease, where your immune system mistakenly attacks your body
- Lack of sleep
- Injury
During an infection or reaction, the facial nerve becomes irritated and inflamed, leading to pressure, lack of blood supply, and swelling. The inflammation causes problems with signaling and muscle weakness or paralysis. In mild cases, the damage might only happen to the covering over the nerve called the myelin sheath.
Bell’s palsy can also look like other conditions, including:
- Stroke
- Lyme disease
- Brain tumor
- Myasthenia gravis, a condition where your immune system attacks communication between nerves and muscles
- Ramsay-Hunt syndrome, where varicella-zoster virus is reactivated and spreads to your facial nerves
If your doctor can’t find an underlying cause of muscle weakness in your face, they might diagnose you with Bell’s palsy.
What are the symptoms of Bell’s palsy?
Bell’s palsy symptoms come on suddenly, especially after being in the cold, and quickly get worse. Early symptoms can include:
- Fever
- Ear pain
- Ringing in your ear
- Stiff neck
- Weakness on one side of your face
- Stiffness on one side of your face
- Drooping on one side of your face
- Twitching in your face
- Trouble talking or eating
Depending on the part of the nerve affected, you might also have Bell’s palsy symptoms like:
- Dry eye
- Loss of taste
- Trouble closing your eye
- Drooling
- Sensitivity to sound
- Headache
- Loss of feeling in your face
Bell’s palsy can look like other conditions, so it’s important to see your doctor.
Who is at risk for Bell’s palsy?
Bell’s palsy can happen to anyone and at any age, but it’s most common between age 15 and 60. It’s more likely to happen with some conditions, including:
- Pregnancy
- Diabetes
- High blood pressure
- Obesity
- Preeclampsia, which causes high blood pressure during pregnancy
- The flu
- A common cold
- Upper respiratory conditions
If you’ve had Bell’s palsy before, you’re also more likely to get it again.
How is Bell’s palsy diagnosed?
Your doctor can usually diagnose Bell’s palsy by looking at it. They’ll take your medical history and ask questions about your symptoms. There are no specific tests for Bell’s palsy, but your doctor might do some tests to rule out other conditions or to check nerve damage. These include:
- Electromyography where they test the electrical activity in your muscles
- X-ray scan
- Magnetic resonance imaging, or MRI
- Computed tomography scan, or CT scan
- Blood tests to check other conditions like diabetes
What is the treatment for Bell’s palsy?
Bell’s palsy usually goes away on its own within 1 or 2 months. Your doctor might give you steroid medications to lower nerve inflammation and repair your nerves. It’s usually best to start these as soon as you have symptoms, but they also don’t work for some people.
Your doctor might also suggest other Bell’s palsy treatments like:
- Massage or electrical stimulation to build muscle tone
- Acupuncture
- Antiviral medications if you have an infection
- Pain relievers like ibuprofen or acetaminophen
- Eye drops
- Eye patch
Sometimes very severe cases can lead to a crooked smile that doesn’t get better or an eyelid that won’t close. You can have surgery to correct the damage though this doesn’t happen very often.
Bell’s palsy treatment also includes taking care of yourself at home. You can:
- Eat healthy foods
- Get plenty of rest
- Wear sunglasses outside
- Use a heating pad to ease pain and swelling
Can you recover from Bell’s palsy?
Most people fully recover from Bell’s palsy. While you generally will get better within a few months, it might take longer if you have a lot of nerve damage. Some people have side effects that last and range from mild to severe.
If you notice muscle weakness in your face or other symptoms, talk to your doctor.
