Bell’s Palsy | Otolaryngology (ENT) | Loyola Medicine

Bell’s Palsy

Overview and Facts about Bell's Palsy

Patients with Bell’s palsy experience a sudden complete weakness on one side of the face. Bell’s palsy can occur at any age as the result of an inflammation of the nerve that controls the muscles on one side of the face. Most commonly, a virus causes that inflammation. Pregnant women or patients with weakened immune systems are at a higher risk of Bell’s palsy.  

Symptoms and Signs of Bell's Palsy

Facial paralysis from Bell’s palsy occurs suddenly (within a number of hours or days). Symptoms include facial weakness on one side of the face, as well as:

  • Difficulty making facial expressions, such as smiling or closing your eye
  • Drooling
  • Pain around the jaw or ear of the affected side
  • Decreased ability to taste
  • Headache
  • Sensitivity to sound (hyperacusis)

Only in rare cases does Bell’s palsy affect both sides of the face. If you notice any of the above symptoms, it is important to see your doctor for accurate diagnosis and the start of a customized treatment plan right away. 

Tests and Diagnosis of Bell's Palsy

Sudden loss of facial function should be promptly seen by a medical professional. Usually, stroke is ruled out as a cause based on clinical history. A physical exam is critical to making the diagnosis, although sometimes imaging (a CT or MRI scan) is performed as well. These tests can help determine other causes of facial nerve damage, such as a fracture or tumor in the head or neck area. To check for signs of Bell’s palsy, your doctor will look at your face and ask you to move your facial muscles by closing your eyes, lifting your brow, showing your teeth and frowning, among other movements.

Causes and Risk Factors of Bell's Palsy

While the exact cause of Bell’s palsy is unknown, there is a potential link to exposure from a viral infection. 

Treatment and Care for Bell's Palsy

Patients with Bell’s palsy need to be treated with steroids (prednisone) as soon as possible.  A three-week tapering course of prednisone is the standard medical treatment. Full recovery occurs in up to 85 percent of patients within one to three months. In patients who do not recover, our specialists consider surgical decompression with or without electrical stimulation.

Occasionally, recovery can be incomplete or marked by facial synkinesis, which can be treated with physical retraining and Botox. 

Facial Retraining

Facial nerve physical therapists at Loyola work with you to develop customized movement patterns that help you re-coordinate the muscles of your face after paralysis from Bell’s palsy. Facial retraining is a non-surgical approach to rehabilitation in which you and a therapist identify the facial muscles that are functioning incorrectly and create strategies to re-establish normal function as much as possible.