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Bell's palsy

Contents of this page:


Ptosis, drooping of the eyelid
Ptosis, drooping of the eyelid
Facial drooping
Facial drooping

Alternative Names    Return to top

Facial palsy; Idiopathic peripheral facial palsy

Definition    Return to top

Bell's palsy is a temporary form of facial paralysis that occurs with damage to the nerve that controls movement of the muscles in the face.

Causes    Return to top

Bell's palsy is a form of cranial mononeuropathy VII. It is the most common type of this nerve damage. Bell's palsy affects about 2 in 10,000 people.

Bell's palsy involves damage to the seventh cranial (facial) nerve. This nerve controls the movement of the muscles of the face. The cause is often not clear, although herpes infections may be involved.

Bell's palsy is thought to be linked to swelling (inflammation) of the nerve in the area where it travels through the bones of the skull. Other conditions related to Bell's palsy include:

Symptoms    Return to top

Symptoms usually start suddenly, and range from mild to severe. They may include:

Exams and Tests    Return to top

Other causes of cranial mononeuropathy VII, such as head injury and tumor, need to be ruled out.

Treatment    Return to top

In many cases, no treatment is needed. The goal of treatment is to relieve symptoms.

Corticosteroids or antiviral (acyclovir and valacyclovir) medications may reduce swelling and relieve pressure on the facial nerve. You must take these drugs early (preferably within 24 hours of when symptoms start) for them to be most effective. However, there are no published studies showing that antiviral medications speed up or improve recovery from Bell's palsy.

Your health care provider may recommend lubricating eye drops or eye ointments to protect the eye if you cannot close it completely. You may need to wear an eye patch during sleep.

Surgery to relieve pressure on the nerve (decompression surgery) is controversial and has not been shown to routinely benefit people with Bell's palsy.

Outlook (Prognosis)    Return to top

About 60 - 80% of cases go away completely within a few weeks to months. Sometimes the condition results in permanent changes. The disorder is not life threatening.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call your health care provider right away if your face droops or you have other symptoms of Bell's palsy. Your health care provider can rule out other, more serious conditions, such as stroke.

Prevention    Return to top

Safety measures may reduce the risk of head injury. Many of the other factors that lead to this disorder are not preventable.

References    Return to top

Tiemstra JD, Khatkhate N. Bell's palsy: diagnosis and management. Am Fam Physician, 2007;76:997-1002.

Update Date: 2/13/2008

Updated by: Luc Jasmin, MD, PhD, Departments of Anatomy & Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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