OverviewYour face droops on one side and you may have a lopsided smile, or an eyelid that won’t close.What is Bell’s palsy?Bell’s palsy causes temporary paralysis, or palsy, of facial muscles. It occurs when a condition, such as a viral infection, causes inflammation and swelling of the seventh cranial nerve (the nerve that controls facial muscles). Show
With Bell’s palsy, your face droops on one side or, rarely, both sides. You may have a lopsided smile, or an eyelid that won’t close. These effects typically last several months and go away without treatment. The condition gets its name from Sir Charles Bell, a Scottish surgeon who first described it during the 19th century. How common is Bell’s palsy?About 40,000 people in the U.S. develop Bell’s palsy every year. Who might have Bell’s palsy?Bell’s palsy affects men and women equally. It typically occurs in people between the ages of 15 and 60. You may be more prone to Bell’s palsy if you are pregnant or have:
Can you get Bell’s palsy more than once?It’s unusual to get Bell’s palsy more than once in a lifetime, but it can happen. A recurrence is most likely within two years of the first incident. The facial nerve palsy may affect the same side of your face or the opposite side. You’re more at risk for a recurrence if you have a family history of the disease. Symptoms and CausesWhat causes Bell’s palsy?Various viruses may trigger Bell’s palsy. The condition occurs when swelling or inflammation temporarily puts pressure on the nerve that controls facial muscles. This pressure impairs the function of the nerve making it difficult for you to control facial muscles or expressions. As the inflammation subsides, the nerve starts to function again. It may take several months for symptoms to go away. What are the symptoms of Bell’s palsy?Symptoms of Bell’s palsy tend to come on suddenly and reach peak severity within 48 to 72 hours. Some people develop mild symptoms. Others experience total paralysis. Symptoms start to gradually improve in three weeks. Up to 80% of people fully recover and show no signs of Bell’s palsy within three months. In addition to facial drooping, signs of Bell’s palsy include:
Diagnosis and TestsHow is Bell’s palsy diagnosed?Your healthcare provider can make a diagnosis based on symptoms. Other conditions, including stroke, sarcoidosis and Lyme disease, can also cause facial paralysis. To rule out those causes, you may have one or more of these tests:
Management and TreatmentHow is Bell's palsy managed or treated?Bell’s palsy improves without treatment. Still, your healthcare provider may recommend one or more of these therapies for symptom relief and a faster recovery:
What are the complications of Bell’s palsy?Eight out of 10 people with Bell’s palsy recover fully without any lingering problems. Unfortunately, 20% of people have long-term facial paralysis and drooping. While uncommon, Bell’s palsy can come back, usually within two years of the initial diagnosis. A recurrence may affect the same side of the face or the opposite side. How does Bell’s palsy affect pregnancy?For unknown reasons, pregnant women are three times more likely to develop Bell’s palsy than women who aren’t expecting. The condition typically occurs during the third trimester. You may be more likely to develop Bell’s palsy while pregnant if you have preeclampsia (high blood pressure) or gestational diabetes. If your symptoms are severe, your healthcare provider may recommend treatment. Certain treatments, such as oral corticosteroids, may increase your risk of giving birth prematurely before the 37th week of pregnancy. Your healthcare provider can discuss treatment risks and benefits with you. PreventionHow can I prevent Bell’s palsy?Currently, there isn’t any known way to prevent Bell’s palsy. Outlook / PrognosisWhat is the prognosis (outlook) for people who have Bell’s palsy?The majority of people who develop Bell’s palsy recover without treatment. You should notice a gradual lessening of symptoms within a few weeks. Depending on the extent of nerve damage, full recovery can take two to six months. Some symptoms last longer, and some people never fully recover. Living WithWhen should I call the doctor?If you experience new Bell’s palsy symptoms, such as facial drooping or paralysis of your face, contact your healthcare provider immediately. Your provider may want to rule out other causes, such as stroke. Starting treatment early may help speed up and improve your chance for recovery. You should also call your healthcare provider if you experience:
What questions should I ask my doctor?If you have Bell’s palsy, you may want to ask your healthcare provider:
A note from Cleveland Clinic If you get Bell’s palsy, you may be embarrassed by the way your face looks. Fortunately, these symptoms gradually improve with time. See your healthcare provider when symptoms first appear. Corticosteroid treatments can speed recovery if you start them within 48 hours of noticing symptoms. Your provider can also rule out other, more serious conditions that cause facial paralysis. What are commonly used medications to treat Bell's palsy?Patients with Bell's palsy should be treated within three days of the onset of symptoms with a seven-day course of oral acyclovir (Zovirax) or valacyclovir (Valtrex), plus a tapering course of oral prednisone.
Which nursing interventions are appropriate for the patient with Bell's palsy?Nursing Management. Cover the eye with a protective shield at night.. Apply eye ointment to keep eyelids closed during sleep.. Close the paralyzed eyelid manually before going to sleep.. Wear wraparound sunglasses or goggles to decrease normal evaporation from the eye.. What is the first line treatment for Bell's palsy?Bell's palsy is a condition where inflammation in the ear puts pressure on the facial nerve, resulting in facial paralysis. First-line treatment is with prednisolone, which should be started within 72 hours of the onset of the palsy because this gives the best chances of recovery.
What is recommended to prevent ophthalmic complications in patients with Bell's palsy?In most cases, topical ocular lubrication (with artificial tears during the day and lubricating ophthalmic ointment at night, or occasionally ointment day and night) is sufficient to prevent the complications of corneal exposure.
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