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Bell’s Palsy

Bell’s palsy is the most common cause of facial paresis/paralysis. Currently, there is no known cause for Bell’s palsy. As a result of the weakness, the patient may have impaired eye closure, which may lead to eye injury. Therefore, eye care is extremely important if there is eye closure weakness. Eye closure weakness prevents eye blinking, which is necessary to keep the eye moist. Eye care may consist of eye drops and/or eye lubricants, and wearing a clear eye patch, for example, to maintain eye moisture.
Treatment of the paralysis consists of oral steroids for patients over the age of 16. Oral steroids should be started within 72 hours of onset of the paralysis. Oral steroids are given to try to shorten the duration of the paralysis and to improve the chance of returning the face to normal movement.

The following are characteristics of Bell’s palsy, but is should be emphasized that Bell’s palsy is a diagnosis of exclusion requiring the careful elimination of other causes of facial paresis or paralysis:

  • Rapid onset (< 72 hours)
  • Typically the condition is self-limited. Most patients with Bell’s palsy show some recovery without intervention within 2-3 weeks after onset of symptoms. Complete recovery often occurs within 3 - 4 months. If there is no recovery within 3 - 4 months, then another cause for paralysis should be considered.
  • May occur in men, women and children, but is more common in persons between 15 - 45 years old.
  • Bell’s palsy is more common in persons with diabetes, upper respiratory ailments, compromised immune function and during pregnancy.
The following is a list of other conditions that can cause facial paralysis:

  • Stoke
  • Brain tumors
  • Parotid tumors
  • Cancer of the ear
  • Varicella zoster
  • Sarcoidosis
  • Lyme disease