Publication date Sep 06, 2007
If you wake up one morning and find your face droops on one side, you may have Bell's palsy. This can be alarming, but most people recover completely.
With Bell's palsy, the muscles of your face suddenly become weak. It happens because a nerve sending messages from your brain to your face muscles stops working. It almost always happens on just one side of the face.
We don't know for certain what causes Bell's palsy. It may be caused by swelling around the nerve, due to a virus.
Not everyone who has weak face muscles has Bell's palsy. About 3 in 10 people have another condition, like an injury or an ear disease. Your doctor will check for these conditions. You won't be diagnosed with Bell's palsy until other problems have been ruled out.
Some people who have a stroke get weakness in the muscles of the face. But this is different from Bell's palsy. If you have a stroke, other parts of your body are usually affected too. You might need some tests, such as an MRI scan or a CT scan, to rule out problems other than Bell's palsy.
About 1 in 60 people get Bell's palsy. Pregnant women seem more likely to get it.
You might find your face droops on one side and it's hard to close or open one eye. You may not be able to frown or smile properly and your speech may be slurred. It's hard to keep saliva (spit) inside your mouth. So you might dribble.
Some people get an ache behind the ear for a few days. But Bell's palsy isn't usually painful. You may find noise uncomfortable. You may lose your sense of taste on the affected side of your tongue.
These things might make you feel anxious or self-conscious.
The symptoms come on quickly. They might get worse over two days.
If you can't close your eye properly, it could get dry and damaged. You may need to use moisturising eye drops, or surgical tape to keep it closed.
Bell's palsy only affects the face. If you feel weak or numb in other parts of your body, you should tell your doctor immediately.
Most people recover from Bell's palsy, whether or not they have treatment. Many people don't have treatment, but there are some you can try.
Taking steroid tablets and antiviral tablets together may help you recover completely from Bell's palsy. They seem to work best if you take them within three days of your symptoms starting. You'll probably need to take the tablets for a week.
These are not the steroids used by some bodybuilders. They are similar to natural chemicals made in your body that damp down inflammation. You'll probably take a steroid called prednisolone (brand name Deltacortil).
Antiviral tablets work on the virus that may be causing the problem. You'll take either aciclovir (Zovirax) or valaciclovir (Valtrex).
Some research shows that people who take steroid tablets and antiviral tablets together have a 9 in 10 chance of recovering completely.
Antiviral medicines can have mild side effects. Some people feel sick and get diarrhoea. Taking steroids for a long time at a high dose can be harmful. Side effects include high blood pressure, diabetes and thinning of the bones. You're unlikely to get these problems if you take steroids for only a week.
If you are pregnant, talk to your doctor or obstetrician before taking any of these medicines.
If your Bell's palsy doesn't go away completely, you may need more treatment.
You could try physiotherapy, where you work with a therapist to strengthen your face muscles. This may help you move your face more normally.
If Bell's palsy leaves you with one eye that does not close properly, you might consider an operation. A surgeon can put a weight into your eyelid to help it close more easily.
You have a good chance of recovering completely from Bell's palsy. This means your face goes back to normal and your muscles work properly. But about 3 in 10 people are left with some muscle weakness.
About 2 in 10 people also get other long-term problems. Your face may look different because your face muscles have shortened. And different parts of your face may move together. So your chin may dimple when you blink. That happens when the nerve in the face grows back in a different way.
These problems can be distressing. You can talk to your doctor about further treatments. You may also find counselling helps you cope with changes to your face.
You're more likely to have long-term problems if:
You might want to talk to other people who have Bell's palsy. The Bell's Palsy Association is a charity that may be able to help. Its website is at http://www.bellspalsy.org.uk.
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice.
If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.