Bell's Palsy

What is a Bell's palsy? 

Your symptoms have been assessed by a qualified health care practitioner and you have been diagnosed to have Bell's palsy. 

This is a temporary paralysis that affects one side of the face. 

Symptoms may include: 

• Weakness of one side of the face, including the mouth, eye and forehead 

• Difficulty closing the affected eye 

• Dryness of the affected eye 

• Loss of taste on the affected side of the tongue 

• Increased sensitivity to sound on the affected side, or loss of hearing 

• Facial pain on the affected side 

These symptoms usually develop over 48-72 hours. 

What causes a Bell's palsy? 

The cause of Bell's palsy is not fully understood. It is believed that symptoms are caused by swelling of the facial nerve, possibly related to reactivation of a viral infection. There is no known way to prevent this. 

How is it diagnosed? 

Your doctor will diagnose Bell's palsy having listened to your symptoms and examining you. In the majority of cases the diagnosis is made by examination alone without the requirement for scans or blood tests. 

What is the prognosis? 

Prognosis is usually very good, and most people make a full recovery within 9 months. In a minority of cases, recovery may be incomplete. 

Persisting symptoms of Bell's palsy may include: 

• Facial weakness 

• Difficulty speaking 

• Eye problems related to persistent 

• irritation and dryness 

• Altered sense of taste or hearing 

• Involuntary facial movements or tear production 

• Mental health problems such as anxiety 

What is the treatment? 

a) Steroids 

Treatment with a 10 day course of steroid tablets can reduce the time to recovery, and make a full recovery more likely. This is most effective if started within 72 hours of symptom onset. 

You will not routinely be prescribed antiviral medication. 

b) Eye care 

This is extremely important, as your eye can be damaged if affected. You may be prescribed artificial tears to use during the day, and lubricant to use during sleep. If you cannot close your eye, it is important to tape it closed whilst asleep to prevent friction damage. You should use gentle tape e.g. Micropore Surgical Tape. 

c) Exercises and massage 

Gentle massage and facial exercises may help facial muscles to recover. These may be done on a daily basis, however It is important not to do forcible exercises. 

Exercises could include: 

• Eyebrow raises and eye closures 

• Flare nostrils and wrinkle nose 

• Smile repetition 

• Neck movements in all directions 

What happens next? 

As most cases of Bell's palsy recover spontaneously, you will not require any routine follow-up. 

However, you should be referred to see an Ear Nose & Throat specialist if you have hearing loss. 

Please arrange to see your GP if you have not recovered after 2 months, or if your symptoms are getting worse. They may refer you to see a specialist. 

If you develop sudden weakness affecting the face, arms or legs, or sudden change to speech or vision, please phone 999. This may be caused by a stroke which is a medical emergency. 

Further information:

https://www.nhs.uk/conditions/bells-palsy/ 

https://www.facialpalsy.org.uk/