Bell’s palsy

Bell's palsy is a condition that causes sudden, temporary weakness or paralysis in the muscles on one side of the face. It happens because a nerve in your face gets damaged or swollen, affecting your facial expressions, taste, and tear production. Sometimes referred to as idiopathic facial paralysis, Bell’s palsy can affect people at any age, but it's more common around age 40. It’s not considered a serious condition, and in most cases it goes away on its own over time. However, some Bell’s palsy symptoms are similar to stroke symptoms. A stroke is a medical emergency, and you should get treatment immediately if you experience muscle weakness in your face.

Doctors called neurologists treat Bell's palsy. Neurologists at Penn Medicine are among the leading neurology providers in the southeastern Pennsylvania and South Jersey region who are dedicated to diagnosing and treating nerve-related problems like Bell’s palsy.

Symptoms of Bell's palsy typically develop suddenly and can range from mild weakness to total paralysis of the affected side of the face, causing one side of the face to droop. Everyone experiences Bell’s palsy differently, but symptoms may include: 

• Difficulty drinking, eating, or speaking 
• Drooling 
• Facial drooping, particularly in the forehead, eyebrow, eyelid, and corner of your mouth 
• Facial or ear pain 
• Headache 
• Inability to blink, close your eye, or squint 
• Inability to control facial expressions like smiling 
• Loss of feeling in your face 
• Loss of taste 
• Ringing in your ears 
• Sensitivity to sound 
• Sudden weakness or paralysis on one side of your face 
• Tears forming in the corner of your eyes 

Bell's palsy symptoms typically peak within 48 hours, but how severe they are can vary from person to person. You may notice early warning signs like a slight fever and pain behind your ear. However, once Bell's palsy begins, there's no way to prevent it from developing further. Symptoms can last for a few weeks to six months, but they often start to improve within three weeks. 

The exact cause of Bell's palsy isn’t fully understood, but it’s believed to result from inflammation or damage to the facial nerve, which controls the muscles in your face. Several factors may contribute to the development of Bell's palsy: 

• Viral infections: The herpes simplex virus, which causes cold sores, is the most common virus linked to Bell’s palsy. Other viruses, including the Epstein-Barr virus, also in the herpes family, and the varicella-zoster virus, which causes chickenpox and shingles, have been associated with the condition. 
• Immune system response: In some cases, Bell's palsy may occur when the body's immune system mistakenly targets the facial nerve, leading to inflammation and swelling. This immune response can interfere with normal nerve function and result in facial weakness or paralysis. 
• Other factors: While less common, other factors such as bacterial infections, stress, traumatic injury to the face or head, tumors, and certain medical conditions may contribute to the development of Bell's palsy in some cases. 

People who are at the highest risk of Bell’s palsy include people who: 

• Are obese 
• Are pregnant or recently gave birth 
• Had Bell’s palsy before 
• Have an upper respiratory infection 
• Have diabetes 
• Have high blood pressure 

Treatment for Bell's palsy is aimed at reducing inflammation, managing symptoms, preventing complications, and promoting recovery. 

Your provider may prescribe medications to reduce inflammation, which can help speed up recovery and improve outcomes. In addition, there are steps you can take to improve pain, discomfort, and muscle stiffness. For example, facial exercises, massage, and electrical stimulation may help maintain muscle tone, improve facial muscle strength and coordination, and prevent long-term muscle weakness. Some individuals benefit from alternative therapies such as acupuncture, relaxation techniques, and biofeedback. Others find that applying warm compresses or moist towels to the affected side of the face offers relief. 

It's important to follow up with your healthcare provider regularly to monitor progress, adjust treatment as needed, and address any concerns or complications that may arise. In most cases, Bell's palsy gets better by itself within a few weeks to months, and most people fully recover their facial movement. However, some patients may experience continued weakness or other issues. If that happens, your Penn Medicine care team will support you throughout your recovery.