Bell's Palsy

Bell's palsy is an episode of paralysis or weakness in the face that starts suddenly. Symptoms may worsen over three to five days then improve over the coming weeks or months. This condition results from problems with the seventh cranial nerve, which carries signals from the brain to the face. Pain and discomfort usually occur on one side of the face or head.

This condition can impact anyone at any age, but it occurs most often in pregnant women and people with diabetes or an upper respiratory illness. Bell's palsy affects men and women equally. It is less common before age 15 or after age 60.

Bell's palsy is not considered permanent, but in rare cases, it does not disappear. Currently, there is no known cure for Bell's palsy; however, recovery usually begins two weeks to six months from the onset of the symptoms. Most people with Bell's palsy recover full facial strength and expression.

Symptoms of Bell's Palsy

While every person may experience Bell’s palsy differently, common symptoms may include the following:

• Difficulty moving muscles that control facial expressions, such as smiling, squinting, blinking, or closing the eyes
• Loss of feeling in the face
• Headache
• Tearing
• Drooling
• Loss of taste on the front two-thirds of the tongue
• Hypersensitivity to sound in the affected ear
• Inability to close the eye on the affected side of the face

The symptoms of Bell's palsy may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

Causes of Bell's Palsy

While the specific cause of Bell's palsy is unknown, the condition is thought to be caused by inflammation in the nerve that controls movement in the face.

Bell’s palsy may be related to infection with a virus, such as the herpes simplex virus (which causes cold sores of the mouth).

Diagnosing Bell's Palsy

There is no exact test for Bell’s palsy, so your doctor may diagnose your condition based on your symptoms and a physical exam. Because the symptoms of Bell’s palsy may be caused by other conditions (including Lyme disease and stroke), your doctor may rule out those diseases by ordering tests, such as blood work, a CT, or an MRI.

Treatments for Bell's Palsy

Your doctor will work with you to determine the best treatment plan based on the severity of your symptoms and your medical profile.

Your treatment may include:

• Eye care, including drops during the day and ointment or a moisture chamber at night to protect the cornea from drying and scratching
• Steroid medications to reduce inflammation
• Antiviral medications, such as acyclovir
• Analgesics or moist heat to relieve pain
• Physical therapy to stimulate the facial nerve

Some patients may choose alternate therapies for Bell's palsy, but there is no proof these methods help. Such treatment may include:

• Relaxation
• Acupuncture
• Electrical stimulation
• Biofeedback training
• Vitamin therapy, including B12, B6, and the mineral zinc

Why Choose Columbia

At Columbia Otolaryngology, our specialists are skilled in the diagnosis and treatment of Bell’s palsy. As part of a leading academic medical center, our expert team draws on the best available therapies to personalize the right care plan for you. We have extensive experience managing Bell’s palsy so that symptoms have minimal impact on your daily life and activities.