Bell’s palsy is a condition that causes a temporary weakness or paralysis of the muscles in the face. It may occur due to a viral or bacterial infection.

It can occur when the nerve that controls your facial muscles becomes inflamed, swollen, or compressed.

The condition causes one side of your face to droop or become stiff. You may have difficulty smiling or closing your eye on the affected side. In most cases, Bell’s palsy is temporary, and symptoms usually go away within a few weeks or months.

Although Bell’s palsy can occur at any age, the condition is more common among people between ages 16 and 60. Bell’s palsy is named after the Scottish anatomist Charles Bell, who was the first to describe the condition.

Bell’s palsy occurs when the seventh cranial nerve becomes swollen or compressed, resulting in facial weakness or paralysis. The exact cause of this nerve damage is unknown, but many medical researchers believe it’s most likely triggered by a viral infection.

The viruses and bacteria that have been linked to the development of Bell’s palsy include:

Many experts believe that something can trigger a dormant viral infection, essentially waking it up and triggering Bell’s palsy. If you’re stressed, or you’ve been sick recently, those could be potential triggers. So could a recent physical trauma or even sleep deprivation. An autoimmune condition is also a possible trigger.

The thought is that the facial nerve reacts to the infection by swelling, which causes pressure in the bony canal (known as the Fallopian canal) that the facial nerve passes through to the side of the face.

According to the National Institute of Neurological Disorders and Stroke, the inflammation of the facial nerve reduces blood flow and oxygen to the nerve cells. This damage to the cranial nerve and nerve cells can cause paralysis of the facial muscles.

The National Organization for Rare Disorders also notes that some people might even have an inherited predisposition to developing Bell’s palsy.

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Credit: Wenzdai Figueroa

The symptoms of Bell’s palsy can vary in severity, from mild weakness to total paralysis. The more inflammation and compression the facial nerve is exposed to, the more severe the paralysis tends to be, and the longer it takes for the nerve to heal and regain function.

The symptoms of Bell’s palsy can develop 1 to 2 weeks after you have a:

The symptoms usually appear abruptly, and you may notice them when you wake up in the morning or when you try to eat or drink.

Bell’s palsy is marked by a droopy appearance on one side of the face and the inability to open or close your eye on the affected side. In rare cases, Bell’s palsy may affect both sides of your face.

Other signs and symptoms of Bell’s palsy include:

  • facial weakness
  • a droopy mouth
  • an inability to make facial expressions, such as smiling or frowning
  • difficulty pronouncing certain words
  • dry eye and mouth
  • altered taste
  • drooling
  • sensitivity to sound
  • difficulty eating and drinking
  • muscle twitches in the face
  • irritation of the eye on the involved side
  • headache

Call your doctor immediately if you develop any of these symptoms. You should never self-diagnose Bell’s palsy. The symptoms can be similar to those of other serious conditions, such as a stroke or brain tumor.

Your risk of developing Bell’s palsy increases if you:

Your doctor will first perform a physical examination to determine the extent of the weakness in your facial muscles. They’ll also ask you questions about your symptoms, including when they occurred or when you first noticed them.

While there’s no specific lab test that your doctor can use to confirm that you definitely have Bell’s palsy, your doctor can use a variety of tests to help make a Bell’s palsy diagnosis.

These tests can also help rule out other possible causes of facial weakness that may need addressing, such as Guillain-Barré syndrome or Lyme disease.

These tests may include:

  • blood tests to check for the presence of a bacterial or viral infection
  • blood tests to check for diabetes or other conditions
  • imaging tests such as an MRI or CT scan to check the nerves in your face and rule out the possibility of a stroke or brain tumor
  • an electromyography (EMG) test, in which a doctor inserts very thin wire electrodes into a muscle to confirm whether there’s any damage to the nerves that control the facial muscles — this test can also determine how much damage there is
  • lumbar puncture may be done if Lyme disease is suspected

In most cases, Bell’s palsy symptoms improve without treatment. However, it can take several weeks or months for the muscles in your face to regain their normal strength.

The following treatments may help in your recovery.

Medication

Your doctor may recommend medications such as:

Home treatment

  • an eye patch (for your dry eye)
  • a warm, moist towel over your face to relieve pain
  • facial massage
  • physical therapy exercises to stimulate your facial muscles

Most people who have an episode of Bell’s palsy will completely recover without complications. However, complications may occur in more severe cases of Bell’s palsy. These include the following:

  • You may have damage to the seventh cranial nerve. This nerve controls your facial muscles.
  • You may have excessive dryness in the eye on your affected side, which can lead to eye infections, ulcers, or even vision loss.
  • You may have synkinesis, a condition in which moving one part of your face causes another to move involuntarily. For example, your eye may close when you smile.

Beyond taking your medication, what else can you do to cope with Bell’s palsy while you wait for it to hopefully resolve?

  • Use artificial tears or eye drops during the day. If your eyelid doesn’t completely close, or you can’t blink, you can develop a pretty significant case of dry eye, also known as exposure keratitis. Without treatment, you might develop some damage to your cornea. Your eye doctor can give you more specific advice on how many times per day to use the drops. If you need to use lubricating eye drops more than four times a day, be sure to use preservative-free eye drops, which won’t irritate your eye.
  • Use a heavy lubricating ointment in your eye at night. This kind of thicker ointment will prevent moisture loss in your eye while you’re sleeping, but it can make your vision blurry. Apply right before you go to sleep.
  • Tape your affected eye shut at night. To prevent your eye from drying out during the night, use surgical tape to close your eyelid when you go to bed. Be gentle with removing the tape when you wake up so as not to damage your eyelid or the skin around your eye.
  • Consider using an eye patch. Some experts suggest placing a patch or moisture chamber over your eye to reduce moisture loss and prevent dry eye.
  • Use a straw. Sometimes it’s hard to drink from a glass when your mouth is droopy. To reduce the likelihood of dribbling water or other beverages down your chin, try using a straw.
  • Talk with someone. If you’re feeling down about your appearance, don’t hesitate to talk about your feelings with a trusted friend or even a counselor or therapist.
  • Consider alternative therapies. Complementary therapies won’t cure your Bell’s palsy symptoms, but they might help you feel better. For example, if you have a favorite relaxation technique or other stress-reduction strategy, consider putting it to use.
  • Try to rest as much as possible. Dealing with facial paralysis and the changes it brings can be stressful. Try to rest as much as you can, get plenty of sleep, and focus on eating nutritious, wholesome foods.

The outlook for people with Bell’s palsy is usually good. Recovery time can vary depending on the severity of nerve damage.

If the nerve damage is mild, you may start seeing an improvement within 2 to 3 weeks of the initial onset of symptoms. If the nerve damage is more severe, it could take 3 to 6 months to start noticing an improvement. In rare cases, symptoms may continue to return or may be permanent.

Call your doctor immediately if you have symptoms of Bell’s palsy. Prompt treatment can help speed up your recovery time and prevent any complications.

Bell’s palsy is a condition that causes weakness or paralysis of your facial muscles, typically just on one side of your face. It happens when the cranial nerve that controls your facial muscles becomes inflamed, swollen, or compressed.

Getting diagnosed with Bell’s palsy can be frustrating. No one really knows for sure what causes it, and there isn’t any medication or treatment that can clear it up quickly. Also, what works for one person may not work for someone else.

Bell’s palsy is usually a temporary condition, but it can still require a lot of patience as you wait for the nerves and muscles in your face to start working again.

Your doctor may be able to help by initiating treatment and providing support. It’s also worth trying a few strategies to lessen the effect on your face — and life — as you look toward recovery.