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Bell's palsy


Disease: Bell's palsy Bell's palsy
Category: Immune diseases
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Disease Definition:

Bell’s palsy is a condition that occurs when the nerve that controls the facial muscles becomes swollen or compressed. Although this condition may occur at any age, however, it rarely affects people over the age of 60 or under the age of 15.

Usually, within a few weeks, the symptoms of Bell’s palsy begin to improve, and within three to six months complete recovery occurs.

About 8 to 10% of people will experience a recurrence of signs and symptoms, sometimes on the other side of the face. However, some people may continue to have some signs and symptoms for life, and never recover.

Work Group:

Prepared by: Scientific Section

Symptoms, Causes


Some of the signs and symptoms of Bell’s palsy include:

  • Headache
  • Loss of taste
  • Pain, usually in the ear on the affected side
  • Sounds that seem louder on the affected side
  • Pain behind or in front of the ear on the affected side
  • Changes in the amount of tears and saliva the body produces
  • Sudden onset of paralysis or weakness on one side of the face, making it difficult to smile or close the eye on the affected side
  • Difficulty with facial expressions and facial droop.


On its way to the face, the nerve that controls facial muscles passes through a narrow corridor of bone. This nerve gets pinched in this tight corridor if it becomes inflamed or swollen, usually from infection with a virus. The protective covering of the nerve can be damaged because of the pressure from the bone, and communication between the nerve and the facial muscles can be blocked, resulting in weakness and paralysis.

The herpes simplex virus seems to be the most common cause of Bell’s palsy, which also causes cold sores and genital herpes. The virus that causes mononucleosis (Epstein-Barr), another virus in the same family (cytomegalovirus) and the virus that causes chickenpox and shingles (herpes zoster) are some of the other viruses that have been linked to Bell’s palsy.



Usually, within a month, a mild case of Bell’s palsy disappears. However, recovery in a case involving paralysis varies. The fibers may be damaged irreversibly if the damage to the facial nerve is unusually severe. In the case of misdirected regrowth of nerve fibers another complication may arise, resulting in involuntary contraction of certain muscles when the patient is trying to move others. For instance, the eye on the affected side may close when the person tries to smile.


Normally, with or without treatment, most cases of Bell’s palsy recover fully. However, in order to speed recovery, a person may be suggested medications or physical therapy. In some rare cases, surgery may be an available option.

Permanent contractures may be caused by the shrinking and shortening of the paralyzed muscles. However, this can be prevented by performing exercises and massaging the facial muscles. To help relieve pain, moist heat may be applied to the face.

Corticosteroids are powerful anti-inflammatory agents; one example is prednisone. The facial nerve will fit more comfortably within the bony corridor that surrounds it if these medications reduce its swelling. Antiviral drugs, such as acyclovir or valacyclovir can stop the progression of the viral infection in case Bell’s palsy is triggered by a virus.

Early treatment with corticosteroids, antivirals or a combination of both types of drugs has shown benefit in some clinical studies. However, not all studies have shown this benefit. These studies have shown that corticosteroids are more effective than antiviral drugs.

In some cases, a person may need plastic surgery to make their face work and look better.
Another way of relieving the pressure on the facial nerve is surgically opening the bony passage through which it passes.


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