Bell Palsy
Bell palsy causes sudden weakness or paralysis on one side of the face. A clinician must first rule out stroke and other causes.
About bell palsy
Bell palsy causes sudden weakness or paralysis on one side of the face. A clinician must first rule out stroke and other causes.
What can cause it?
Bell palsy is thought to involve inflammation of the facial nerve, often after viral reactivation.
Stroke, Lyme disease, ear disease, tumors, and other neurologic conditions can mimic it.
What a patient may notice
Symptoms vary from person to person. Possible signs may include:
- Sudden facial droop on one side
- Difficulty closing one eye or smiling
- Drooling, altered taste, or pain near the ear
How clinicians find the cause
A clinician checks the pattern of facial weakness, eye closure, speech, limb strength, hearing, rash, and other neurologic findings. Blood tests or imaging may be needed when the presentation is atypical.
Treatment and next steps
- 1
Treatment is most effective when started early and may include prescribed corticosteroid medicine.
- 2
Eye protection is essential when the eyelid does not close completely; lubricating drops, ointment, or taping may be recommended.
- 3
Treatment for another cause is needed when examination points away from Bell palsy.
Supporting recovery
- Protect the affected eye from dryness and injury exactly as directed.
- Eat carefully if food collects in the weak side of the mouth.
- Do not delay evaluation of new facial droop.
What to expect
Most people recover completely within several weeks to months, especially when weakness is incomplete and improvement begins early. Some people have lasting facial weakness, tightness, or involuntary facial movements. Eye protection remains important until full eyelid closure returns.
Possible complications
- Dryness or injury of the cornea when the affected eye cannot close completely
- Persistent facial weakness, muscle spasm, or involuntary linked movements
- Long-term changes in taste, tearing, speech, or eating
When to Contact a Medical Professional
A same-day medical evaluation is recommended, especially when symptoms are severe, worsening, or accompanied by fever, vomiting, weakness, or significant pain.
Call 911 for facial weakness with arm or leg weakness, trouble speaking, severe headache, confusion, dizziness, or vision loss.Get emergency help for severe trouble breathing, new chest pressure, fainting, seizure, sudden weakness on one side, uncontrolled bleeding, blue or gray lips, or a person who is difficult to wake.
Ways to lower risk
- Bell palsy usually cannot be prevented.
- Tick protection may reduce Lyme disease, one possible mimic in endemic areas.
Trusted health information
This CHS patient-education page uses original wording and links to MedlinePlus for additional information.