Bell’s palsy is one of the most common causes of sudden weakness or paralysis of the facial nerve, which usually causes one side of the face to droop. It occurs in 20 to 30 people out of every 100,000, and occurs five times more often in people with diabetes.
Drooping or weakness in the face — whether sudden or gradual — can also be a sign of stroke, and should be evaluated as soon as possible.
The facial nerve is one of the main nerves arising from the brainstem, and it controls facial muscle movement. There is one nerve for each side of the face. Bell’s palsy almost always causes paralysis in one facial nerve, causing that side of the face to droop. But in rare cases, it can affect both sides of the face.
Although the cause of Bell’s palsy is unclear, it can be associated with viral illness, infections, pregnancy, and diseases like multiple sclerosis, which affects multiple nerves.
Early evaluation and treatment are vital to increase the chance of total recovery. Your doctor may order an MRI to eliminate other possible causes of facial weakness, including neurological disorders and tumors of the brain and salivary glands.
Bell’s palsy treatment involves high doses of oral steroids. Research shows that other medications such as antiviral medicine have no impact on the chance of recovery following Bell’s palsy. Surgery can be an option in some cases of Bell’s palsy, but to be effective, it must be done within two weeks of the onset of symptoms.
With early intervention, the prognosis for Bell’s palsy is very good. If the facial nerve is not totally paralyzed by the disease, up to 95 percent of patients will regain complete function of the facial nerve within 2 to 3 months. If the nerve is completely paralyzed, the odds of a complete recovery are slightly less (80 percent to 85 percent).
If facial muscle function does not completely recover, surgical and minimally invasive options are available that help restore symmetry to the face. These are most often performed by one of our expert facial plastic surgeons or oculoplastic surgeon.
Trauma to the bone surrounding the ear (temporal bone) is another common cause of facial nerve paralysis. Such trauma can cause hearing loss, dizziness and other ear complaints.
There is also an association between Bell’s palsy and Lyme Disease. If you develop facial nerve weakness, be sure to tell your physician if you have recently traveled to a Lyme Disease area or have a history of a tick bite or rash.