5 Things You Need to Know About Bell's Palsy

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1. It Looks Like a Stroke, But It's Not a Stroke

What is a Bell's palsy? It's a paralysis of the muscles on one side of the face. This facial paralysis causes a drooping of the mouth on that side. It also makes closing the eye on that side quite difficult. Bells palsy symptoms leave a person looking like they've had a stroke, but it is a completely different problem. A Bell's palsy is a peripheral neuritis, an inflammation of the nerve that supplies the facial muscles. The brain is unaffected. It only affects the facial muscles.

2. Don't Guess--See a Doctor

Don't try to decide if you have a Bell's palsy or a stroke. A stroke is a much more serious problem, sometimes requiring immediate intervention. Let a doctor make the diagnosis! Even if it is indeed a Bell's palsy causing your facial weakness, treatment is possible. Treatment is far more effective if initiated early on. DON'T WAIT!

3. It's a Virus--Maybe

There are a variety of theories about what causes Bell's palsy. The most widely accepted theory is that it is caused by inflammation from a viral infection. The inflammation causes the nerve to swell, and as the nerve passes through its opening in the skull, located behind the ear, pressure "squeezes" it. How tightly it is squeezed determines how much damage is done. It's also felt that there is a genetic predisposition making some people more likely to get the problem.

4. The Treatment Works--Maybe

There are two basic forms of bells palsy treatment. One involves the use of steroids (prednisone) to decrease swelling. The other involves the use of anti-viral medications because of the assumption that it is a viral infection that has triggered the process. There are some experts who do not feel that either treatment works, but steroid therapy is widely used (anti-virals, less commonly). A third form of treatment, surgical decompression of the nerve, is a rarely considered option. Studies have not demonstrated the effectiveness of any other treatments and that includes all vitamin supplements and forms of alternative medicine.

5. It Usually Gets Better

The good news concerns Bell's palsy recovery. Most people who develop a Bell's palsy experience complete resolution of the problem. The largest studies of the problem show that 85% of patients improve completely. 10% of patients have a very mild degree of residual weakness. 5% of patients experience a severe, ongoing problem. One of the important secondary problems that can be avoided is damage to the eye from not being able to close it. This involves the use of long-acting artificial tears and taping the eye closed at night. Recovery time for a Bells palsy varies from weeks to months.

About this Author

J.R. Waggoner practiced family medicine for 30 years then embarked on a second career as a medical journalist and author. He has written a number of op/eds that have appeared in The Journal of the American Medical Association as well as many national publications. In 2007 he published a book, Medical Metamorphosis--The three step cure for America's health care crisis.

Last updated on: 11/18/09

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