Bell's palsy is a rare illness that causes a problem with the nerves in a person's face. This nerve trouble can paralyze one side of the face and make the person look different because that one side is frozen or droopy. The condition might cause pain and it might make the person feel uncomfortable about his or her appearance.
Only a small number of kids get Bell's palsy (say: pol-zee), and not many grownups get it, either. For those who do get it, the good news is that usually goes away on its own.
What Is Bell's Palsy?
Bell's palsy weakens or paralyzes the muscles on one side of the face. When something is paralyzed, it can't move, so half of the person's face might look stiff or droopy. The paralysis does not last forever, but someone who has it will have trouble moving one side of his or her face.
Bell's palsy can develop over a matter of days. Because it can happen suddenly, someone might think the problem is a stroke — when a blood vessel in the brain gets clogged or bursts. Like Bell's palsy, a stroke can paralyze a person's face. But Bell's palsy is caused by nerve trouble and isn't as serious as a stroke. Bell's palsy can be scary, but it usually doesn't last long and goes away without treatment.
Bell's palsy was named after a Scottish doctor, Sir Charles Bell, who studied the two facial nerves that direct how the face moves. You have one facial nerve for each side of your face. These nerves send messages from the brain to the face. Through these messages, the facial nerves control the muscles of your face, forehead, and neck.
Facial nerves control the expressions you make — like raising your eyebrows, squeezing your eyes shut, or smiling. Each facial nerve starts in the brain, goes through the skull in a narrow tube of bone, and exits the skull behind the ear. From there, it splits into smaller branches of nerves that attach to the muscles of the face, neck, and ear. Other small nerve branches run to the glands that make saliva, the glands that make tears, and the front of the tongue.
Remember that narrow tube of bone that holds the facial nerve? When the facial nerve is infected or damaged, it swells up and presses against the inside of that bony tube. The nerve gets squashed, and it can't send signals to the muscles in the face, the salivary glands, or the tongue anymore. This problem paralyzes the face and then the person has Bell's palsy.
What Causes Bell's Palsy?
Most doctors believe Bell's palsy can be caused by anything that irritates the facial nerve. Sometimes its cause is unknown, but most of the time a virus causes Bell's palsy. Another cause, especially in kids and teens who live near wooded areas, is Lyme disease. And a few women develop Bell's palsy while they're pregnant.
Other things that may bring on Bell's palsy include:
- injury, like getting hit really hard in the face
- the flu or a bad cold
- diabetes
- ear infections
- the virus that causes cold sores, herpes simplex
About 40,000 people in the United States develop Bell's palsy each year. There's no foolproof way to prevent it, but regular hand washing is a smart step because it can prevent the spread of viruses.
What Are the Symptoms of Bell's Palsy?
Symptoms may come on all at once or show up bit by bit over a few days. Usually, they reach their worst point within a few days. After that, someone with Bell's palsy can look forward to getting better in a couple of weeks.
Symptoms of Bell's palsy may include:
- twitching, weakness, or stiffness on one side of the face
- half of the face drooping (especially one corner of the mouth)
- trouble closing one eye
- dryness in one eye
- difficulty speaking, eating, or drinking
- headache
- pain behind or in front of one ear
- loss of taste at affected parts of the tongue
- changes in the amount of saliva in the mouth
- hearing sounds louder in one ear
How Is It Diagnosed?
Doctors often can diagnose Bell's palsy by just looking at the person because the face has a certain look. To be sure, the doctor might do tests like an MRI or CT scan, which take pictures of the inside of the head, to make sure nothing else is causing the facial weakness.
Sometimes a neurologist (say: nyoo-ral-uh-jist) — a doctor who focuses on how the nervous system works — will do a test called electromyography (say: eh-lek-troh-my-ah-grah-fee) or EMG. An EMG can show how well the face's muscles are receiving signals from the facial nerve. The neurologist may do another test to check for nerve damage.
How Is It Treated?
Because the facial nerve often repairs itself, doctors usually just help the person deal with the symptoms until they get better. It's rare that a doctor would do surgery for Bell's palsy. Instead, he or she might prescribe medicine to reduce the swelling or fight the virus to help speed up recovery.
Massages can keep the facial muscles stretchy so that they can bounce back quickly once the nerve heals. Someone with Bell's palsy will likely need eye drops (and maybe an eye patch) for a while. A few people might have continuing problems with one eye, their sinuses, or facial muscles, but most people make a full recovery. The symptoms may go away suddenly or get better a little bit each day.
Living With Bell's Palsy
While a person has it, Bell's palsy can be tough to deal with. A kid might be upset about looking different than usual, or angry or sad that this happened to him or her. And patience is needed because of various doctor appointments. Then even more patience is needed while the kid waits for the problem to get better.
What should a kid do while waiting to get better? Follow the usual good advice: Get rest and eat good-for-you foods. Your mom or dad can help you treat problems, such as needing eye drops. Most of the time, Bell's palsy doesn't last long so you'll be looking and feeling like yourself again soon.
Reviewed by: Mena T. Scavina, MD
Date reviewed: April 2009
