Bell's Palsy

Reviewed on 8/19/2022

What Is Bell's Palsy?

Bell's Palsy
Bell's palsy is the sudden weakness of muscles on one side of the face, usually associated with trauma, infection, or other causes. Bell's palsy is usually temporary.
  • Named after Surgeon Sir Charles Bell's and also known as facial palsy, Bell's palsy is the sudden weakness of one side of the face.
  • It is often temporary and is attributed to the inflammation of the facial nerve that controls the muscles on the weakened side of the face.

What Causes Bell's Palsy?

The direct cause is not usually known, but Bell's palsy is often preceded by symptoms of a viral syndrome.

Other commonly mentioned triggers include:

There is a strong correlation with the herpes simplex virus, the same virus that causes cold sores or fever blisters on the lip. There has also been an association found with shingles and its associated blistering (from the herpes zoster virus). Bell's palsy has been associated with Lyme disease. The facial muscle is the most commonly paralyzed nerve of the body.

What Are Bell's Palsy Symptoms and Signs?

The symptoms commonly develop over hours or days. Men and women are affected equally. The most common symptoms include:

  • Weakness or complete paralysis of an entire side of the face
  • An eyelid droop
  • Drooling from the affected side of the mouth
  • Pain around the ear
  • Feeling of fullness or swelling to the affected side of the face
  • Impaired hearing or sense of taste
  • Inability to wrinkle the forehead

When to Seek Medical Care for Bell's Palsy

All episodes of facial weakness or paralysis should be immediately examined by a doctor to rule out the possibility of a stroke. If you have had a previous episode of Bell's palsy and have another similar episode, you should be examined again to rule out other more serious causes of the facial weakness.

Other causes of facial weakness can include these conditions:

If you have any difficulty with speech (slurred speech or change in speed of your conversation), arm or leg weakness, numbness, tingling, or difficulty with balance or walking, call 911 or go to an emergency department.

How to Test for Bell's Palsy

Your symptoms and the physical examination by your doctor is often the most important part in making a diagnosis of Bell's palsy. Often no tests are needed for adequate diagnosis.

If X-rays are taken, however, most likely a CT scan or MRI of your head will be performed. This X-ray is only necessary if your doctor suspects a stroke, tumor, or another serious neurological disease as the cause of your symptoms.

What Are Bell's Palsy Treatment Options?

Treatment for Bell's palsy may include medication, electrostimulation, or a combination of these strategies.

Are There Home Remedies for Bell's Palsy?

After examination by a doctor and with a proper diagnosis, you can begin facial exercises and stimulation of the facial muscles. The following measures may help speed up your recovery:

  • Relieve minor pain with over-the-counter pain medication such as ibuprofen (Motrin).
  • Keep the droopy eyelid taped shut at night. Keep your eye moist with proper eyedrops (such as methylcellulose type) to prevent drying of the surface of your eye.

What Is the Medical Treatment for Bell's Palsy?

Electrostimulation of the muscles has been used for treatment, but its effectiveness has not been proven.

What Are Bell's Palsy Medications?

Steroids, such as prednisone (Deltasone), can reduce the duration of symptoms by decreasing the inflammation of the nerve.

Doctors will often add an antiviral agent, such as acyclovir (Zovirax) or valacyclovir (Valtrex), because of a strong correlation between herpes simplex virus and Bell's palsy.

If Lyme disease is possible in certain areas of the country, an antibiotic may be added, such as doxycycline.

Is It Possible to Prevent Bell's Palsy?

The cause of Bell's palsy is often unknown, so prevention is not possible.

What Is the Prognosis for Bell's Palsy?

Bell's palsy usually goes away by itself without treatment. Most people begin recovery in 2 to 3 weeks, with 70% to 85% of people showing complete recovery in 2 to 3 months. There is a 10% recurrence rate.

Those who are at a higher risk of not getting completely better are often older and those who have a slow recovery from symptoms.

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Can COVID-19 Cause Bell's Palsy?

At first, COVID-19 was believed to be primarily a respiratory illness. But as the virus has spread across the world, neurological symptoms were reported including headaches, loss of taste, and loss of smell.

There have been rare case reports of Bell's palsy that accompany COVID-19 infection. The connection still remains unclear, but since Bell’s palsy is thought to be caused by viral infections, it may be possible it could be caused by the coronavirus, the virus that causes COVID-19. More study is needed.

Reviewed on 8/19/2022
Ronthal, Michael, and Patricia Greenstein. "Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults." May 11, 2020. <>.

Ronthal, Michael, and Patricia Greenstein. "Bell's palsy: Prognosis and treatment in adults." Aug. 5, 2020. <>.