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Bell's palsy
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Diagnosis
There's no specific test for Bell's palsy. Your
health care provider 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.

Other conditions — such as a stroke, infections,

Lyme disease, inflammatory conditions and
tumors — can cause facial muscle weakness that
mimics Bell's palsy. If the cause of your
symptoms isn't clear, your health care provider
may recommend other tests, including:

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Electromyography (EMG). This test can

confirm the presence of nerve damage and
determine its severity. An EMG measures
the electrical activity of a muscle in
response to stimulation. It also measures
the nature and speed of the conduction of
electrical impulses along a nerve.

Imaging scans. Magnetic resonance

imaging (MRI) or computerized tomography
(CT) may be needed on occasion to rule out
other possible sources of pressure on the
facial nerve, such as a tumor or skull
fracture.

Blood tests. There is no blood test for

Bell's palsy. But blood tests can be used to
rule out Lyme disease and other infections.

More Information

CT scan

Electromyography (EMG)

MRI

Show more related information

Treatment
Most people with Bell's palsy recover fully — with
or without treatment. There's no one-size-fits-all
treatment for Bell's palsy. But your health care
provider may suggest medications or physical
therapy to help speed your recovery. Surgery is
rarely an option for Bell's palsy.

Because the eye on the affected side doesn't

close, it's important to take steps to protect and
care for that eye. Using lubricating eye drops
during the day and an eye ointment at night will
help keep your eye moist. Wearing glasses or
goggles during the day and an eye patch at night
can protect your eye from getting poked or
scratched. In severe cases of Bell's palsy, an eye
doctor may need to monitor the eye.

Medications
Commonly used medications to treat Bell's palsy
include:

Corticosteroids, such as prednisone.

These are powerful anti-inflammatory
agents. If they can reduce the swelling of
the facial nerve, the nerve will fit more
comfortably within the bony corridor that
surrounds it. Corticosteroids may work best
if they're started within several days of when
your symptoms started. Steroids started
early improve the likelihood of complete
recovery.

Antiviral drugs. The role of antivirals

remains unsettled. Antivirals alone have
shown no benefit compared with placebo.
Antivirals added to steroids may benefit
some people with Bell's palsy, but this is still
unproved.

Despite this, an antiviral drug, such as

valacyclovir (Valtrex) or acyclovir (Zovirax),
is sometimes given in combination with
prednisone in people with severe facial
palsy.

Physical therapy
Paralyzed muscles can shrink and shorten, which
may be permanent. A physical therapist can
teach you how to massage and exercise your
facial muscles to help prevent this from
occurring.

Surgery
In the past, decompression surgery was used to
relieve the pressure on the facial nerve by
opening the bony passage that the nerve passes
through. Today, decompression surgery isn't
recommended. Facial nerve injury and
permanent hearing loss are possible risks
associated with this surgery.

Rarely, plastic surgery may be needed to correct

lasting facial nerve problems. Facial reanimation
surgery helps make the face look more even and
may restore facial movement. Examples of this
type of surgery include an eyebrow lift, an eyelid
lift, facial implants and nerve grafts. Some
procedures, such as an eyebrow lift, may need to
be repeated after several years.

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Lifestyle and home remedies

Home treatment may include:

Taking pain relievers. Aspirin, ibuprofen

(Advil, Motrin IB, others) or acetaminophen
(Tylenol, others) are available without a
prescription and may help ease your pain.

Doing physical therapy exercises.

Massaging and exercising your face
according to your physical therapist's advice
may help relax your facial muscles.

Alternative medicine
Although there's little scientific evidence to
support the use of alternative medicine for people
with Bell's palsy, some people with the condition
may benefit from the following:

Acupuncture. Placing thin needles into a

specific point in your skin helps stimulate
nerves and muscles, which may offer some
relief.

Biofeedback training. By teaching you to

use your thoughts to control your body,
biofeedback training may help you gain
better control over your facial muscles.

Botulinum toxin. This medication may help

manage symptoms such as facial spasms
and tearing. Injections of botulinum toxin
may also help improve symmetry of the
face.

Preparing for your

appointment
You'll likely start by seeing your family doctor or
other health care provider. However, in some
cases when you call to set up an appointment,
you may be referred immediately to a doctor who
specializes in the nervous system (neurologist).

It's good to prepare for your appointment. Here's

some information to help you get ready.

What you can do

Write down any symptoms you're
experiencing. Be sure to include any that
may seem unrelated to the reason for which
you scheduled the appointment.

Write down key personal information.

Have you had any major stresses or life
changes recently? Sharing this type of
information may help with a diagnosis.

Make a list of all medications. Include the

dosage of any medications you're taking.
Write down any vitamins or supplements
that you're taking, too.

Take a family member or friend along, if

possible. Sometimes it can be difficult to
remember all of the information during an
appointment. Someone who accompanies
you may remember something that you
missed or forgot.

Write down questions you want to ask.

Preparing a list of questions will help you make

the most of your time with your provider. For
Bell's palsy, some basic questions to ask include:

What's the most likely cause of my

symptoms?

Are there any other possible causes for my

symptoms?

What kinds of tests do I need?

Is this condition likely temporary or long

lasting?

What treatments are available for Bell's

palsy? Which do you recommend?

Are there alternatives to the primary

approach that you're suggesting?

I have other health conditions. How can I

best manage these conditions together?

Are there any brochures or other printed

material that I can take home with me?
What websites do you recommend?

Don't hesitate to ask any additional questions

that occur to you during your appointment.

What to expect from your doctor

Be prepared to answer questions such as:

When did you begin having symptoms?

Have your symptoms been continuous or

occasional?

How severe are your symptoms?

What, if anything, seems to improve your

symptoms?

What, if anything, appears to worsen your

symptoms?

Have any of your relatives ever had Bell's

palsy or problems with facial paralysis?

Have you had any symptoms of a more

generalized infection?

What you can do in the meantime

If you have facial pain:

Take pain relievers. Aspirin, ibuprofen

(Advil, Motrin IB, others) or acetaminophen
(Tylenol, others) can help with pain.

Apply moist heat. Putting a washcloth

soaked in warm water on your face several
times a day may help relieve pain.

If your eye won't close completely, try these tips:

Use your finger to close your eye repeatedly

throughout the day.

Use lubricating eye drops.

Wear eyeglasses during the day to protect

your eye.

Wear an eye patch at night.

By Mayo Clinic Staff

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Symptoms & causes

Doctors & departments

May 04, 2022

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Related
Facial nerve

Facial paralysis

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