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Bell's Palsy
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Brain Nerves

Bell's Palsy

Bell's palsy is the most common cause of facial paralysis, typically affecting one side of the face with symptoms that appear suddenly.

Symptoms

Symptoms of Bell's palsy usually appear suddenly, reaching their peak intensity about 48 hours after onset. They range from mild to severe and include:

  • Twitching
  • Weakness
  • Paralysis
  • Drooping eyelid or corner of mouth
  • Drooling
  • Dry eye or mouth
  • Excessive tearing in the eye
  • Impaired ability to taste

Causes and Risk Factors

Scientists believe that a viral infection causes the facial nerve to become inflamed or swollen. Individuals who are pregnant, diabetic, or currently suffering from a cold or flu are at a higher risk of developing the condition.

Prognosis

Three out of four patients improve without treatment. Most individuals begin to recover within two weeks and achieve a complete recovery within three to six months, regardless of whether they receive treatment.

Frequently Asked Questions

Because the eyelid cannot close properly, the eye is at high risk of drying out and corneal damage. You must use preservative-free artificial tears frequently during the day and a lubricating ointment at night. Taping the eye shut with medical tape before sleep is often necessary to prevent exposure keratopathy. If you notice redness, pain, or vision changes, seek immediate ophthalmologic care.
The key difference is that Bell's palsy affects only the face, while a stroke often involves other parts of the body. In Bell's palsy, the forehead is usually paralyzed, so you cannot raise your eyebrows on the affected side. In a stroke, the forehead is typically spared, meaning you can still raise your eyebrows. Additionally, stroke symptoms often include slurred speech, weakness in the arm or leg, or confusion. If you suspect a stroke, call emergency services immediately.
Steroids like prednisone can suppress the immune system, potentially making it harder to fight off a new viral infection. However, stopping steroids abruptly is dangerous. You should contact your healthcare provider immediately to discuss whether to adjust the dosage or continue the course, especially since viral infections are a suspected trigger for Bell's palsy. Do not stop medication without medical guidance.
This phenomenon is called synkinesis, where nerves have regrown but connected to the wrong muscles. For example, you might smile when you try to close your eye. While this can be cosmetically concerning, it is not dangerous. Treatment options include botulinum toxin injections to relax the overactive muscles and facial physical therapy to retrain muscle control. Early intervention with a specialist can improve outcomes.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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