|Bell's Palsy: Facial Droop|
|Copyright © Nucleus Medical Media, Inc.|
- Pain behind the ear that is followed by weakness and paralysis of the face
- Ringing sound in the ears
- Slight fever
- Slight hearing impairment
- Slight increase in sensitivity to sound on the affected side.
- Facial weakness or paralysis (look for smooth forehead and problems smiling)—most often on one side
- Numbness just before the weakness starts
- Drooping corner of the mouth
- Decreased tearing
Inability to close an eye, which can lead to:
- Dry, red eyes
- Ulcers forming on the eye
- Problems with taste
- Sound sensitivity in one ear
- Slurred speech
- Long-lasting tightening of the facial muscles
- Tearing from eye while chewing
- Hearing test—to see if nerve damage involves the hearing nerve, inner ear, or hearing mechanism
- Balance test—to see if balance nerves are involved
- Lumbar puncture—a test of the cerebrospinal fluid (CSF) from the lower back; to rule out meningitis, autoimmune disorders, or cancer spreading from a tumor
- Tear test—measures the eye's ability to produce tears
- computed tomography (CT) scan—a type of x-ray that uses a computer to make pictures of structures inside the head to see if there is an infection, tumor, bone fracture, or other problem in the area of the facial nerve
- Magnetic resonance imaging (MRI) scan—a test that uses magnetic waves to make pictures of structures inside the head to see if there is an infection, tumor, bone fracture, or other problem in the area of the facial nerve
- Electrical test (NCM/EMG)—to evaluate for damage to the facial nerve
- Blood tests—to check for diabetes, HIV infection, or Lyme disease
- Appling lubricant or putting drops in the eye.
- Covering and taping eye closed at night.
- Wearing an eye patch to keep the eye closed. This helps moisten and keep particles out of the eye.
Bell's Palsy Information Site http://www.bellspalsy.ws/
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/
Alberta Health and Wellness http://www.health.gov.ab.ca/
Health Canada http://www.hc-sc.gc.ca/
American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/bellsPalsy.cfm. Accessed September 20, 2012.
Bell’s palsy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated July 25, 2012. Accessed September 20, 2012.
Bell’s palsy fact sheet. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/bells/bells.htm. Updated September 4, 2012. Accessed September 20, 2012.
Finsterer J. Management of peripheral facial nerve palsy. Eur Arch Otorhinolaryngology. 2008;265:743-752.
Grogan PM, Gronseth GS. Practice parameter: steroids, acyclovir, and surgery for Bell’s palsy (an evidence based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56:830-6.
Kasper DL, Braunwald E, Fauci AS, et al. Harrison's Principles of Internal Medicine. 16th ed. New York, NY: The McGraw-Hill Companies; 2005.
Bell's palsy . American Family Physician website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/bells-palsy.html . Updated February 2011. Accessed September 20, 2012.
Primary Care Medicine. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000.
Quant EC, Jeste SS, Muni RH, et al. The benefits of steroids versus steroids plus antivirals for treatment of Bell's palsy: a meta-analysis. BMJ. 2009;339:b3354.
Rakel RE, Bope ET. Conn's Current Therapy. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.
Russell J. Bells palsy. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation.
Samuels MA, Feske SK. Office Practice of Neurology. Philadelphia, PA: Churchill Livingstone; 2003.
11/6/2007 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: Sullivan FM, Swan IR, Donnan PT, Morrison JM, et al. Early treatment with prednisolone or acyclovir in Bell's palsy. N Engl J Med. 2007;357:1598-1607.
1/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: Engstrom M, Berg T, Stjernquist-Desatnik A, et al. Prednisolone and valaciclovir in Bell's palsy: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet Neurol. 2008;7:993-1000.
9/15/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: Goudakos JK, Markou KD. Corticosteroids vs corticosteroids plus antiviral agents in the treatment of Bell palsy: a systematic review and meta-analysis. Arch Otolaryngol Head Neck Surg. 2009;135:558-564.
9/15/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: de Almeida JR, Al Khabori M, Guyatt GH, et al. Combined corticosteroid and antiviral treatment for Bell palsy: a systematic review and meta-analysis. JAMA. 2009;302:985-993.
- Reviewer: Rimas Lukas, MD
- Review Date: 10/2012 -
- Update Date: 10/11/2012 -