Overview

Bell’s Palsy

Bell’s palsy is a type of facial nerve paralysis. It’s not clear what causes it. Experts think it may result from a viral infection that leaves your facial nerve inflamed. Facial muscles — usually on just one side of your face — become weak or unable to move.

With time, symptoms usually resolve. But they can be alarming, and they should be evaluated quickly. Other more serious conditions can cause similar problems and must be ruled out. If you do have Bell’s palsy, early treatment can increase your chances of a full recovery.

Symptoms and diagnosis

Quick evaluation is key

Seeing a doctor at the earliest signs of Bell’s palsy is important.

Symptoms

Symptoms come on suddenly over one to three days. Because your facial nerve has many different functions, these symptoms can be varied. They may include: 

  • Change in sense of taste on one side of your tongue

  • Change in tear production

  • Decreased saliva production

  • Increased drooling

  • Difficulty closing your eye

  • Difficulty with facial expressions such as smiling

  • Pain around the ear on the affected side

  • Sensitivity to loud sounds

  • Weakness or paralysis on one side of your face

Diagnosis

It’s important to get medical attention within 72 hours of the onset of symptoms. Doctors will review your medical history and perform a physical exam. They will rule out known causes of facial paralysis. If they don’t find another cause, it’s likely Bell’s palsy.

Treatments and research

Early treatment, better results

Bell’s palsy often resolves on its own within three months. Certain treatments can still be beneficial if they’re given soon after your symptoms develop.

Treatment types

Facial paralysis often makes it hard to close your eyes. If you can’t close them completely, it’s important to take special care of your eyes even before you visit a doctor. This may prevent permanent eye damage. You should:

  • Use a moisture chamber at night.

  • Use an eye patch or eye taping when sleeping after discussing this with your eye doctor.

  • Use eye drops such as “artificial tears” frequently during the day.

  • Use over-the-counter eye ointment at night. Within seven to 10 days of starting the ointment, be sure to see an eye doctor.

  • Wear wraparound sunglasses when outside.

If given within 72 hours of the start of your symptoms, high-dose oral steroids help your chances of making a full recovery. We may recommend anti-viral drugs as well.

Several surgeries may be helpful in the first few weeks after symptoms begin.

Eyelid weight surgery may be possible for people who find it difficult to close their eyes completely. This surgery involves placing a small weight in your eyelid. We may recommend it if you’ve had facial paralysis for longer than 14 days but fewer than three months. After you recover, we remove the weight.

Facial nerve decompression relieves pressure on your facial nerve. Sometimes the nerve is so inflamed it gets squeezed near your inner ear. This surgery must take place less than two weeks after paralysis starts. Ask your primary care doctor about seeing an ear surgeon. The surgeon can determine if this treatment is right for you.

Botox injections are another option for eyelids that don’t fully close. The injection helps relax your muscles so that your eyelids can shut.

If your paralysis doesn’t go away after three months, we recommend scheduling an appointment at our Facial Nerve Clinic. The clinic offers a full line of treatments that may help correct any remaining symptoms.

Facial nerve clinic

Meet our team

The expertise you need

At UW Health, we have a complete team of experts who specialize in facial nerve paralysis. Team members include ear, nose and throat specialists, ear surgeons, head and neck surgeons and others. If your doctor thinks you need further evaluation, we’re here to help. We’re also available to assist if you’re living with symptoms that did not improve.

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Ear, Nose and Throat Services

Patient and support services

Answers for your questions, resources to help

The following resources may help you better understand your condition. They can help prepare for your visit to the Facial Nerve Clinic.

Location

Find a location near you

Visit us at one of our convenient locations.

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  • University Hospital - Facial Nerve Clinic
    • 600 Highland Ave. / Madison, WI
    • (608) 263-6190
    • Closed now
    • We provide a unique approach bringing together experts from multiple medical specialties including.This combined expertise provides the highest level of facial reconstruction and helps remove confusion about which specialists to see.

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