Bell's palsy 

Introduction 

Bell's palsy

Bell’s palsy is the temporary weakness or paralysis of the muscles in one side of the face. In this video, a speech therapist explains who is most at risk and describes common causes and treatment options available. Helen explains how she dealt with the condition and recovered from it.

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Bell's palsy is a condition that causes temporary weakness or paralysis of the muscles in one side of the face. It is the most common cause of facial paralysis.

Other causes of facial paralysis include:

  • congenital facial palsy – children born with facial weakness
  • injury to the facial nerve in an accident – such as a cut to the cheek or skull base fracture
  • injury from surgery – which is most common during surgery of the parotid gland and neck

What are the symptoms?

The symptoms of Bell’s palsy vary from person to person. The weakness on one side of the face can be described as either:

  • partial palsy, which is mild muscle weakness
  • complete palsy, which is no movement at all (paralysis) – although this is very rare

Bell's palsy can also affect the eyelid and mouth, making it difficult to close and open them. In rare cases, it can affect both sides of a person’s face.

Read more about the symptoms of Bell's palsy

When to seek medical advice

As well as being a symptom of Bell's palsy, facial weakness or paralysis can also be a sign of a more serious condition – such as a stroke.

Visit your nearest A&E department immediately or call 999 for an ambulance if you or someone you are with develops sudden facial paralysis, so a doctor can determine the cause.

Bell's palsy is only diagnosed if other possible causes of your symptoms are ruled out.

Read more about diagnosing Bell's palsy.

Why does it happen?

Bell's palsy is believed to occur when the nerve that controls the muscles in your face becomes compressed.

The exact cause is unknown, although it's thought to be because the facial nerve becomes inflamed, possibly due to a viral infection. 

The herpes virus is thought to be the most common cause but other viruses may also be responsible.

Read more about the causes of Bell's palsy

Who is affected?

Bell's palsy is a rare condition that affects about one in 5,000 people a year. It's most common in people aged 15-60, but people outside this age group can also suffer from the condition. Both men and women are affected equally.

Bell's palsy is more common in pregnant women and those with diabetes and HIV, for reasons that are not yet fully understood.

Treating Bell's palsy

Around seven out of 10 people with Bell's palsy make a complete recovery, with or without treatment.

Most people notice an improvement in their symptoms after about two to three weeks but a complete recovery can take up to nine months. The recovery time varies from person to person and will depend on the amount of nerve damage.

Prednisolone, a type of corticosteroid, is used to reduce the swelling of the facial nerve.

Eye drops may be required to prevent problems if you are unable to close your eye. Tape may also be used to close the eye while sleeping.

Read more about treatments for Bell's palsy.

Complications

Around three in 10 people with Bell’s palsy will continue to experience weakness in their facial muscles, and two in 10 will be left with a more serious long-term problem.

Complications include:

  • persistent facial weakness
  • eye problems
  • difficulty with speech, eating and drinking
  • reduced sense of taste
  • facial muscle twitching

Bell's palsy may reoccur in up to 14% of people, especially if there is a family history of the condition.

Read more about the complications of Bell's palsy.




Page last reviewed: 14/10/2014

Next review due: 14/10/2016

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Comments

The 10 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Still standing said on 29 October 2014

When I had the Bells Palsy it took me discussing my symptoms with six different GP's and one nurse.
The first GP said my face looked ok, although I had twitching around my mouth and left eye and left ear symptoms.
I then went to A&E two days later, GP there said yes Bells palsy but as it was getting near 72 hrs may be too late for antiviral and steroids. I got home and queried this with my mother so I phoned 111. GP number 3 said I was right and as I still had until 9am next morning for 72 hrs to be up to go to my local GP surgery. Visited GP surgery and spoke to GP number 4. Got antiviral prescription she said 5 days and 5 tablets a day. Spoke to nurse on 111 a few days later she said may take 3 weeks to see a bit of improvement. Four days later I phoned 111 and asked spoke to GP number 5. It was Saturday night so got appt to see GP at hospital out of hours. Next morning saw GP number 6 advised I should be taking antivrals for 7 days not 5.
So this Bells Palsy I needed to speak to six GP's, one nurse and did alot of my own research on the web!

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Still standing said on 11 October 2014

I had Bell Palsy recently, it began as my left ear vibrating and the GP said the drum looked flat. I had some twitching around my mouth and left eyelid. The next day I woke up and my face had the palsy, my left eye was dry and my mouth was pulling to the left. I visited A&E it had been 62 hours since I had the palsy, the doctor said as I was getting near the 72 hour stage antivirals may not work. I came home and phoned 111, I queried the 72 hour time frame with the doctor and he said I was right. I visited my GP next morning and then started antiviral tabets. 7 days of Acyclovir 800mg (five times a day).

My face from start of the Bells Palsy to full recovery took three weeks. I made myself sleep as much as I could, eat well, stay at home. I had fatigue from the second week and some dizziness. When I yawned my mouth was painful so I was yawning with mouth closed as much as I coud. I was advised not to exercise the mouth when I had the palsy.

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User853681 said on 11 March 2014

We're a charity raising awareness and supporting people affected by facial paralysis. We are currently running a survey and are seeking responses from people who have had Bell's palsy. To take part please copy and paste this link into your browser: http://fluidsurveys.com/s/bells-palsy-survey-260214/

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emmad252 said on 02 July 2013

I have been a sufferer of Bells Palsy since the age of 12. I woke up one morning with complete paralysis on the right hand side of my face. My NHS doctor was very unhelpful and basically told my parents that I had to go away and deal with it as there was no treatment available to someone of my age. We sort help from a private doctor at a local Private hospital who was fantastic. Although the treatment received did not cure my symptoms, his care was fantastic. The cause of my bells palsy was narrowed down to a nasty cold sore I had a few weeks before hand. Having suffered with cold sores since the age of the Doctor determined this was most definitely the cause of the palsy.
I still suffer the affects of the palsy now at the age of 25. The muscles surrounding my eye twitch when i talk and my eye becomes droopy when i'm tired. I have looked in to botox for this but am a bit apprehensive that the results will be what I want. My mouth is not even when I smile. and becomes worse when I am tired or run down. I cannot raise my right eyebrow properly and m nose on the right hand side does not wrinkle when I screw my face up.
Luckily whilst pregnant my palsy did not become worse.
It isn't easy living with Bells Palsy. I feel the effects of it everyday. I'm very cautious of my eye twitching when I talk and the fact I cannot produce a straight smile. However people rarely notice it...unless they have known me for a long time and are aware of it.

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lawsona2004 said on 12 July 2012

I suffered from Bells Palsy at the age of 16, whilst sitting my school exams. I remember looking in the mirror one evening and not being able to smile. I believe I had a severely sore head just prior to the paralysis beginning. My GP prescribed a short course of steroids, which he said my cause some weight gain. I also took vitamin B complex and the doctor gave me some facial exercises. The worst fear for me was ''will this be permanent?'', expecially at my age. I remember struggling to eat, sometimes sleep with my eyes still open and watering and looking like I had either had a stroke or been to the dentist. Fortunately, my symptoms gradually improved over 6 months. I was left with a watery eye which droops slightly when I'm tired, but otherwise ok.

However, 10 years later at the age of 26 with my first pregnancy I got Bells Palsy again on the other side of my face. I recovered slightly faster this time and without any medication.

I'm 38 now and hope that I never get it again!

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Missmarie said on 24 January 2012

I was a very rare case of bells palsy. I do not really remember a lot of it as I was two at the time. As you can imagine, when I woke up with a drooping face my parents were worried sick. I am now seventeen and I have recovered from this, however, I will sometimes see pictures of me and my right eye ( the side of my ace that was affected) will be mostly closed. This also happens when I'm tired and when the sun is in my eye. My mouth will still occasionally do this as well. It is quite horrible knowing this happens and it used to really embarrass me. I am okay with it all now, it's been 15 years, I can now accept it, and I'm proud of that. I'm unique because of it.

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depressed21 said on 20 December 2011

It is three years ago this month that i woke up to find the right side of my face had dropped, despite quick treatment with firstly steroids then Aciclovir it took over three months to see any improvement. Even today I still have a problem with my eye which waters when I eat and droops a lot of the time. On a cold day I can even feel my mouth starting to drop. I live my life as before but it does get me down, especially the last few months as I am sure its getting worse! Any tips on how to improve the condition? Is it too late for Acupuncture? would a dose of botox stop the eye lid from drooping? can my doctor help?

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Shirley Brown said on 29 November 2011

I first had Bell's Palsy 10 years ago when my second child was about 2 weeks old. I didn't notice the symptoms developing, but woke to find one side of my face completely paralysed. I chose not to have any medication as I was breastfeeding and the drugs recommended are too strong to take while breastfeeding. The condition began to improve after a few weeks, but it was a few months before my face was back to normal. At the weekend (just gone) I was eating my breakfast and noticed my mouth was feeling numb, I was really scared I was getting it again. I knew I wanted to use drugs this time to reduce its effects. I went to the Walk in Centre at the RD&E and the kind doctor showed me the latest research and said I could choose which drugs I wanted. She then prescribed anti-virals - Aciclovir 400mg - 25 tablets, 5 taken a day and steroids Prednisolone 5mg, 10 a day. The drugs are working really well. My face didn't get any worse and I am hoping for a full recovery in a much quicker time. So my advice would be take the steroids and anti-virals. Good luck.

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Tregeare said on 28 November 2011

Cecil Martin, the former professional American footballer who provides expert comment to Sky TV's NFL content, is a sufferer from Bell's Palsy, which he associated with a burst eardrum from an airline trip. He still seems to have some cosmetic issues after a year or so, but it doesn't affect his input otherwise.

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LoBo04 said on 19 April 2011

I am a moderator of a Bells Palsy website. I appreciate that the NHS is providing information about Bells Palsy. The basics of BP were there and this may be the aim of the video. I do think a few important things were missing from the video, however.

It could be helpful for people with BP to know that there can be pain, extreme fatigue and dizziness. The emotional and social aspects of BP could have been addressed. It is sometimes frightening to experience these things without being warned that they are common symptoms.

I'm concerned about suggesting PT at 3 months. PT, done early, can actually make a slow healer's residuals worse. There are not many PTs familiar with BP and willing to take the slow and gentle approach. I hope each person considering PT will investigate to find a therapist trained in NeuroMuscular Retraining.

The woman interviewed looks wonderful and will help people with BP know that they can recover fully. I wonder why this woman was mainly shown from her non-affected side when drinking, etc.?

I appreciate that the basic information about BP was presented clearly in a manner easily understood. The woman interviewed was charming and an inspiration to anyone with BP.

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