Bell’s palsy, also known as facial nerve palsy, is paralysis of the facial nerve that causes one side of the face to droop. It is the most common cause of paralysis in the face.
Bell’s palsy affects both men and women, most often between ages 15 and 45. Most people recover completely. It cannot be prevented.
The cause is inflammation or damage to a nerve in the face (facial nerve). It is unclear why it occurs, but an infection, such as with a virus, may lead to it. Sometimes, bites from ticks carrying Lyme disease can result in Bell’s palsy.
Symptoms can start suddenly and be distressing. Some people have mild weakness in the face. Others have severe symptoms such as not being able to close the eye or move half of the face. Sometimes complete paralysis occurs in hours. Symptoms also include being unable to raise the eyebrows or having drooping eyebrows, chewing problems, drooling, drooping eyelid, dry eye, ear pain, facial droop, facial numbness, partial loss of hearing and taste, sounds heard as too loud, and tearing. For most people, symptoms go away completely; sometimes facial weakness remains permanently.
The health care provider takes a medical history and checks the ears, nose, and mouth. The health care provider may in some cases get a CT or MRI scan of the brain and blood tests to look for other causes of Bell’s palsy. A doctor who treats nerve problems (neurologist) may in some cases order a special test called electromyography (EMG) to study how the nerve works and predict chances of recovery.
Most people with mild symptoms get all better without medicine. Medicines can help severe symptoms. The medicines (e.g., corticosteroids such as prednisone) reduce inflammation (swelling) in the nerve. If an infection such as Lyme disease is suspected to be the cause of Bell’s palsy, the health care provider may give medicine to treat the infection. An eye patch or eye drops or ointment will protect an open eye, which is critical. Rarely, people who don’t recover completely will have an operation to reduce pressure on the facial nerve or improve facial movements.
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