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NeurologicalICD-10: G51.0Affects approximately 15-30 per 100,000 people annually

Bell's Palsy

Also known as: Facial Palsy, Idiopathic Facial Paralysis, Facial Nerve Paralysis

Bell's palsy is a sudden, temporary weakness or paralysis of the muscles on one side of the face, caused by inflammation or swelling of the facial nerve (cranial nerve VII). The condition typically develops rapidly over 24 to 72 hours, causing drooping of the mouth, inability to close the eye, and loss of facial expression on the affected side. Most people recover fully within 3 to 6 months, though some may experience residual weakness or synkinesis.

Symptoms

Sudden weakness or paralysis on one side of the face
Drooping of the mouth and difficulty smiling
Inability to close the eye on the affected side
Drooling and difficulty eating or drinking
Loss of taste on the front two-thirds of the tongue
Pain or discomfort around the jaw or behind the ear
Increased sensitivity to sound (hyperacusis) on the affected side
Excessive tearing or dry eye

Causes

  • Inflammation and swelling of the facial nerve within the temporal bone
  • Viral reactivation, most commonly herpes simplex virus (HSV-1)
  • Other viral infections including varicella-zoster, Epstein-Barr, and cytomegalovirus
  • Compression of the facial nerve leading to demyelination

Risk Factors

  • Pregnancy, particularly in the third trimester or first week postpartum
  • Upper respiratory infections such as cold or flu
  • Diabetes mellitus
  • Family history of Bell's palsy
  • Age between 15 and 45 years

Diagnosis

  • Clinical examination assessing facial muscle movement and symmetry
  • Electromyography (EMG) to evaluate nerve damage severity
  • MRI or CT scan to rule out stroke, tumor, or other structural causes
  • Blood tests to check for diabetes, Lyme disease, or viral infections

Treatment

  • Oral corticosteroids (prednisone) started within 72 hours of onset
  • Antiviral medications (valacyclovir) in combination with steroids
  • Eye protection with artificial tears, lubricating ointment, and an eye patch
  • Physical therapy and facial exercises to maintain muscle tone
  • Surgical decompression of the facial nerve in rare, severe cases

Prevention

  • No specific prevention for Bell's palsy is known
  • Manage chronic conditions such as diabetes to reduce risk
  • Practice good hygiene to prevent viral infections
  • Seek prompt medical treatment if facial weakness develops

When to See a Doctor

  • You experience sudden facial weakness or drooping on one side
  • You cannot close your eye or have difficulty eating or drinking
  • Symptoms do not improve after several weeks of treatment
  • You are unsure whether symptoms are from Bell's palsy or a stroke

Frequently Asked Questions

Related Conditions

Stroke

Cardiovascular

Migraine

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Epilepsy

Neurological

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Medical Disclaimer: This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider.

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