Bell’s palsy
The facial nerve supplies the muscles of the face. Bell’s palsy is weakness of one side of the face due to problems with the facial nerve. We don’t know what causes Bell’s palsy. Some people think it is because the nerve gets swollen and squashed in the skull on its way to the face. People with Bell’s palsy develop weakness of one side of their face over hours to days. We think you may have Bell’s Palsy.
What other symptoms can Bell’s palsy cause?
You may also have:
- pain around your ear
- mouth problems: problems chewing, a dry mouth and a change in taste
- eye problems: being unable to close your eye, dry eyes or more tears
- some numbness or tingling of your cheek or mouth
- dribbling and problems speaking because of problems moving and closing your mouth
- being unable to tolerate loud noises
Will it improve?
For most people symptoms will start to improve within 2 to 3 weeks. This can happen even without treatment. Most people will completely recover within 3 to 4 months. You have a better chance of recovery if you start steroid treatment in the first 3 days of your symptoms.
About one in six people with Bell’s palsy will have long-term weakness of the face. If your symptoms do not settle within 6 months, your GP should refer you to a specialist doctor.
What is the treatment for Bell’s palsy?
We will start you on steroid medicine if you came to hospital within 3 days of your symptoms starting. This is usually prednisolone; 50mg once a day for 10 days. This treatment may help your facial weakness to improve. You may be given a medicine against viruses but only if an Ear, Nose and Throat (ENT) doctor feels it is right for you. If you cannot close your eye properly you might need treatment to protect your eye.
What eye care might I need?
If your eye does not close completely you will be sent home with:
• eye drops - put these in your eye every couple of hours, up to 6 times a day, to keep the surface moist
• tape - you must tape your eye closed overnight to avoid damage to the surface of your eye
• eye ointment - you should put this in at night time before taping your eye closed
What can I do to help with eating and drinking?
You can use a straw for drinks and eat soft food, if you are finding it hard to eat or drink. If you are getting lots of problems with a dry mouth you can get treatments from your GP to help with this.
When should I see a doctor again?
See a doctor straight away if you get any pain in your eye or changes in your sight. They can check your eye to look for any damage.
It is important that you organise follow up with your GP so that they can check that things are improving. You should have a follow-up appointment, 3 weeks after your symptoms started.
When else do I need to get seen again?
You should seek urgent medical attention if you get:
- eye pain or discomfort, or changes in your sight
- worsening weakness of your face after the first 3 days
- headaches or pain in your face
- swelling of your face
- fevers or are unwell
- weakness or change in sensation in your arms or legs
- any other problems affecting the nerves in your head and neck
- problems with your balance
If you have any concerns outside of this list, you can contact your GP for advice.
What support is available to me?
Bell’s Palsy can be emotionally and physically challenging. Facial Palsy UK provides online information and support. They also have information about local support groups.
Reviewed by Dr Thomas Shaw in September 2023, next review in September 2026.
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