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Bell's palsy 

What is Bell's palsy?

It is a condition where the muscles on one side of the face become paralysed because of a fault in the nerve (called the facial nerve) that controls those muscles. We are not certain what causes this problem, although a viral infection affecting the nerve or the nearby ear may be a cause in some instances. The facial nerve leaves the brain through a very small hole in the base of the skull near the ear. The nerve becomes swollen, and because of the tight fit in this hole it does not work properly.

What are the symptoms?

The main symptom, which comes on quite suddenly (maybe overnight), is weakness of one side of the face. The corner of the mouth droops, the eye cannot close properly and actions of the face such as smiling and frowning look out of shape. Some ear pain may be felt just before the problem develops.

How common is Bell's palsy?

Each year about 1 person in 2000 gets Bell's palsy. It can occur at any age, but is most common in young adults.

What is the outcome?

Although scary, Bell's palsy is usually not a serious or permanent problem. At least 90 per cent make a good recovery. The slow and steady recovery takes about 4 months. Operations to help correct the problem are used occasionally for those rare cases where recovery is not complete.

What is the treatment?

The palsy usually recovers without special treatment. If you see the doctor as soon as it develops, a course of steroid tablets may be prescribed.

Care of the eye

If your eye cannot close fully, it is important to protect it from injury such as dust and grit by wearing goggles and putting a patch over the eye at night. The eye should not be allowed to dry, and artificial tears are usually prescribed. Report any unusual pain in your eye immediately.

Massage and exercises

Massage and exercises to the facial muscles may help recovery. Using oil or cream, massage the muscles of the forehead, cheek, eyes and lips. Exercise these muscles in front of a mirror by screwing up the eyes tightly to close them, smiling widely, baring the teeth and winking.

General care

Continue your normal activities, but choose a good lifestyle by getting plenty of rest and sleep, avoiding smoking and excess alcohol.

Keep a positive outlook on life. Remember that your somewhat embarrassing problem should soon settle.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia