Bell's Palsy

ExitCare ImageBell's palsy is a condition in which the muscles on one side of the face cannot move (paralysis). This is because the nerves in the face are paralyzed. It is most often thought to be caused by a virus. The virus causes swelling of the nerve that controls movement on one side of the face. The nerve travels through a tight space surrounded by bone. When the nerve swells, it can be compressed by the bone. This results in damage to the protective covering around the nerve. This damage interferes with how the nerve communicates with the muscles of the face. As a result, it can cause weakness or paralysis of the facial muscles.

Injury (trauma), tumor, and surgery may cause Bell's palsy, but most of the time the cause is unknown. It is a relatively common condition. It starts suddenly (abrupt onset) with the paralysis usually ending within 2 days. Bell's palsy is not dangerous. But because the eye does not close properly, you may need care to keep the eye from getting dry. This can include splinting (to keep the eye shut) or moistening with artificial tears. Bell's palsy very seldom occurs on both sides of the face at the same time.

SYMPTOMS

  • Eyebrow sagging.

  • Drooping of the eyelid and corner of the mouth.

  • Inability to close one eye.

  • Loss of taste on the front of the tongue.

  • Sensitivity to loud noises.

TREATMENT

The treatment is usually non-surgical. If the patient is seen within the first 24 to 48 hours, a short course of steroids may be prescribed, in an attempt to shorten the length of the condition. Antiviral medicines may also be used with the steroids, but it is unclear if they are helpful.

You will need to protect your eye, if you cannot close it. The cornea (clear covering over your eye) will become dry and can be damaged. Artificial tears can be used to keep your eye moist. Glasses or an eye patch should be worn to protect your eye.

PROGNOSIS

Recovery is variable, ranging from days to months. Although the problem usually goes away completely (about 80% of cases resolve), predicting the outcome is impossible. Most people improve within 3 weeks of when the symptoms began. Improvement may continue for 3 to 6 months. A small number of people have moderate to severe weakness that is permanent.

HOME CARE INSTRUCTIONS

  • If your caregiver prescribed medication to reduce swelling in the nerve, use as directed. Do not stop taking the medication unless directed by your caregiver.

  • Use moisturizing eye drops as needed to prevent drying of your eye, as directed by your caregiver.

  • Protect your eye, as directed by your caregiver.

  • Use facial massage and exercises, as directed by your caregiver.

  • Perform your normal activities, and get your normal rest.

SEEK IMMEDIATE MEDICAL CARE IF:

  • There is pain, redness or irritation in the eye.

  • You or your child has an oral temperature above 102° F (38.9° C), not controlled by medicine.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.