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What is Bell’s Palsy?

Bell鈥檚 palsy is the most common cause of facial paralysis, first described by Sir Charles Bell in 1821. One in 60 people will experienceBell's Palsy patient at 黑料网 Facial Nerve Center Bell鈥檚 palsy during their lifetime. While 70% of patients make a complete recovery from Bell鈥檚 palsy, 30% of people do not fully recover and develop chronic facial asymmetry, facial tightness, synkinesis, and other symptoms of chronic Bell鈥檚 palsy.

Bell鈥檚 palsy is caused by reactivation of the herpes virus within the facial nerve. This virus reactivation leads to swelling of the facial nerve. The swollen facial nerve becomes compressed by the temporal bone (the bone on which the ear sits) and the nerve fibers suddenly stop working. This sudden damage to the facial nerve leads to the common presenting symptoms of Bell鈥檚 palsy:

  • Sudden facial paralysis (occurs within 1-3 days of onset)
  • Taste changes
  • Sensitivity to loud noises
  • Discomfort in the ear and area around the ear
  • Speech difficulty
  • Drooling
  • Spilling liquids out of the corner of the mouth

Patients with suspected Bell鈥檚 palsy should be evaluated by a healthcare provider immediately. The provider will perform a complete neurologic exam and may perform blood tests and imaging studies to rule out other causes of facial paralysis. If the facial paralysis is complete, an electromyography (EMG) or electroneurography (ENoG) study may be performed to quantify how much facial nerve damage is present. If the diagnosis is confirmed to be Bell鈥檚 palsy, patients will typically be prescribed high-dose steroids (e.g., Prednisone) and an antiviral (e.g., Valtrex). It is very important patients with acute Bell鈥檚 palsy protect their eyes using eye drops, eye ointment, and eye taping. These eye care precautions improve comfort of the eye and protect its surface.

Recovery from Bell鈥檚 Palsy

Since the facial nerve remains intact, patients with Bell鈥檚 palsy will improve as the nerve fibers regenerate. This improvement can occur within a few days of paralysis onset, or it can take a few months to occur. This unpredictability can be very difficult for patients, and it is normal to feel disheartened and sad during the recovery process. Patients typically experience an improvement in facial tone (i.e., resting symmetry) and then will begin to see facial movements return. Many times, the regenerating facial nerve establishes proper connections with the facial muscles and the recovery is complete. However, sometimes the facial nerve makes abnormal connections with facial muscles as it regenerates (aka aberrant nerve regeneration), which results in long-term sequelae of Bell鈥檚 palsy:

  • Facial asymmetry
  • Smile asymmetry
  • Facial synkinesis: Involuntary facial movements such as eye closing with smile
  • Narrowing of the eye
  • Facial tightness
  • Neck tightness
  • Deep nasolabial fold (aka smile lines)
  • Chin dimpling
  • Platysma banding

Bell鈥檚 Palsy Treatments

Many patients with Bell鈥檚 palsy have been told there is nothing that can be done to improve their smile, facial asymmetry, eye narrowing, and other long-term manifestations. This is NOT true! There are many treatments that can improve facial symmetry and function in patients with Bell鈥檚 palsy:

Bell's Palsy Patient before and after - 黑料网 Facial Nerve Center
Bell's Palsy Patient before and after treatment - 黑料网 Facial Nerve Center
Bell's Palsy Patient before and after treatment at the 黑料网 Facial Nerve Center

Consultation at the 黑料网 Facial Nerve Center

Dr. Miller is an expert at evaluating and treating patients with Bell鈥檚 palsy. As both a facial paralysis surgeon and a facial paralysis patient, he understands how difficult it can be for patients to cope with their facial paralysis. As an expert in evaluating and treating patients with Bell鈥檚 palsy, Dr. Miller will ensure the correct diagnosis is made and work with patients to develop a personalized treatment plan. He understands each Bell鈥檚 palsy patient is unique and treatment should be customized to the patient. Dr. Miller is happy to see you for a consultation visit, whether you have just been diagnosed or have lived with Bell鈥檚 palsy for years!

To schedule a consultation visit, please call 984-974-2255.