Bell's Palsy


What is Bell's Palsy?

Bell's palsy is a temporary facial paralysis or weakness on one side of the face due to nerve damage or trauma1. The nerve damage, often caused by inflammation, leads to a loss of muscular control, resulting in a droopy face, an asymmetric smile, and typically the partial closure of one eye. Bell's palsy2 can also affect tear and saliva production, as well as the sense of taste. The onset of the condition is sudden but tends to resolve itself in a matter of weeks.

Facial weakness can be caused by other more serious medical conditions. If you experience sudden muscle weakness on one side of the face, it is important to consult a medical professional for an accurate diagnosis.

Symptoms of Bell's Palsy

Symptoms of the disorder include:

  • Numbness, mild weakness or complete paralysis on one side of the face that causes the face to droop
  • Uncontrolled facial distortion Difficulty making facial expressions and an inability to fully smile
  • Difficulty closing one eye
  • Ectropion (an outward turning lower eyelid)
  • Drooling
  • Pain in or behind the ear or around the jaw on the affected side
  • Increased sensitivity to sound
  • Excessive tearing in one eye or dry eye
  • Headache or neck pain
  • Impaired taste

Bell's palsy generally occurs on one side of the face, however, in rare cases, it can be bilateral. If both sides of the face or other parts of the body become weak or numb, it is especially important to rule out other causes.

Possible Causes

Bell's palsy can arise due to a compressed, swollen or inflamed facial nerve. However, the exact cause of the facial nerve damage is not precisely known. Currently, Bell's palsy is thought to be related to certain viral infections, which cause inflammation of the nerves. Some viral infections potentially associated with Bell's palsy include:

  • Viral meningitis
  • Herpes simplex, the virus that causes the common cold sore
  • Influenza or flu-like illnesses

Other health conditions associated with Bell's palsy include diabetes, chronic middle ear infections, headaches, tumors, and a skull fracture or injury.


A doctor will make a diagnosis of Bell's palsy based on clinical symptoms–only after ruling out other causes of facial paralysis, including stroke or other neurological conditions. During the examination, the doctor will evaluate the ability to move the upper and lower facial muscles. Other tests that the doctor may order include:

  • Electromyography (EMG): used to confirm nerve damage and determine the extent of the damage.
  • Magnetic resonance imaging (MRI) or computed tomography (CT): used to determine if there are other sources of pressure on the facial nerve.
  • Blood analysis: used to identify other potentially related health issues, such as infections and diabetes.


Treatment for Bell's palsy will vary from individual to individual. In mild cases, symptoms typically improve over a few weeks and treatment is not needed. For other patients, treatment with certain medications may be recommended, especially when an infection is known to be involved. Some therapeutic options include:

  • Corticosteroids to reduce facial swelling and inflammation.
  • Antiviral drugs such as acyclovir to accelerate recovery for an underlying viral cause.
  • Over-the-counter pain relievers to alleviate discomfort.
  • Eye drops or artificial tears and ointment to keep the eye lubricated and moist.
  • Physical therapy or facial massage to stimulate nerve recovery.

To prevent complications with an affected eye, it is very important to protect it. In addition to lubricating treatment, the eye may be taped shut as an added measure. In severe cases where the eyelid is turned outward (ectropion), surgery may be needed.

The prognosis for Bell's palsy is very good and most people recover completely in three to six months.  Recurrence of Bell's palsy is rare; however, the condition may return, afflicting either side of the face.

At Beach Eye Medical Group, our expert eye doctors can help manage and treat Bell's palsy. Contact us for a consultation.

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