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Definition

Bell palsy is a sudden weakness on one side of the face.

Bell Palsy: Facial Droop
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Causes

The exact cause is not known. It is thought to be a result of an infection that affects the nerve. Herpes simplex virus and Lyme disease are some examples.

Risk Factors

The risk of bell palsy may be highest in:

  • Those with diabetes
  • Third trimester of pregnancy

Symptoms

Symptoms may start all at once or get worse over 48 hours. People may have:

  • Twitching, weakness, or paralysis, most often on 1 side
  • Drooping corner of the mouth
  • Drooling
  • Drooping or problems closing an eye, which can cause dry eye
  • Excess tears from an eye
  • Loss of taste
  • Sensitivity to sounds
  • Pain in the jaw or ear
  • Headache
  • Dizziness

Diagnosis

The doctor will ask about your symptoms and past health. A physical exam will be done. This is often enough to make the diagnosis. Some people may need to see an eye specialist.

Treatment

Bell palsy can get better on its own within a few weeks. Full healing may take 3 to 6 months. Treatment may be needed to manage more severe symptoms.

  • Corticosteroids may be given to ease swelling. They may be given with antiviral medicine to ease severe symptoms in some people.
  • Eye care may be needed if they eyelid cannot close properly. Eye care may include:
    • Lubricant or eye drops
    • Covering and taping the eye closed at night
    • An eye patch to keep the eye closed
  • Physical therapy may be needed. Facial exercises can help during recovery.

Prevention

There are no methods to prevent Bell palsy.

RESOURCES

Centers for Disease Control and Prevention  http://www.cdc.gov 

National Institute of Neurological Disorders and Stroke  http://www.ninds.nih.gov 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Public Health Agency of Canada  http://www.phac-aspc.gc.ca 

References

Bell's palsy. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/bells-palsy.html. Accessed October 11, 2020.

Bell's palsy. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/?q=node/1465. Accessed October 11, 2020.

Bell’s palsy information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Bells-Palsy-Information-Page. Accessed October 11, 2020.

de Almeida JR, Guyatt GH, et al. Management of Bell palsy: clinical practice guideline. CMAJ. 2014 Sep 2;186(12):917-922.

Schwartz SR, Jones SL, Getchius TS, Gronseth GS. Reconciling the clinical practice guidelines on Bell’s palsy from the AA-HNSF and the AAN. Neurology. 2014;82(21):1927-1929.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 10/2020
  • Update Date: 12/12/2020