Bell's palsy

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VOL 114 / NO 2 / AUGUST 2003 / POSTGRADUATE MEDICINE

You woke up to find one side of your face drooping, making it difficult to speak clearly and to eat. Your doctor tells you that you have Bell's palsy, a condition that affects about 40,000 people in the United States each year.

What is Bell's palsy?
It is a sudden loss of control over the movement of one side of the face. Bell's palsy can be very upsetting because it occurs with no warning over just a day or two and makes the face appear lopsided.

What causes Bell's palsy?
This condition occurs when a nerve that travels from the brain to the face becomes swollen. When the nerve swells, the nerve's blood supply gets cut off, nerve cells die, and the nerve can no longer carry messages back and forth from the brain to the face.

The cause of Bell's palsy is not known, but most experts believe that the nerve swells because it is infected by a virus such as the herpes (her-peez) simplex virus, which also causes cold sores. This virus can live in the body for years and may be activated when the body is under physical or emotional stress. Bell's palsy is not spread from person to person.

What are the symptoms of Bell's palsy?
In Bell's palsy, one side of the face sags and it is difficult or impossible to close the eye on that side. As a result, that eye may water during the day and become dry at night. Speaking may be a challenge because the affected side of the mouth is drawn toward the unaffected half of the face. Some people may lose their sense of taste on the affected side of the tongue, and some notice that sounds seem especially loud in the ear on that side of the face.

Who is most likely to get Bell's palsy?
This condition most commonly affects people in their teens or 20s and those over age 60. Pregnant women, people with diabetes, and people who have the flu or a cold also are at higher risk. Children can have Bell's palsy, but it's uncommon.

How is Bell's palsy treated?
Most people can recover from Bell's palsy without any medication. However, patients with Bell's palsy generally are given both a steroid medication, such as prednisone, and an antiviral medication, such as acyclovir, within the first 2 or 3 days after symptoms appear. Early treatment with this combination of drugs improves the odds of a full recovery by about 20%. The good news is that many patients begin to feel significantly better within about 2 weeks. About 70% of patients recover fully within several months, and about 15% feel better by that time but report that their face still feels a little weak. About 10% to 20% of people who have Bell's palsy have it more than once in their lifetime.

For more information on Bell's palsy

Bell's Palsy Information Site
http://www.bellspalsy.ws

Medlineplus, National Library of Medicine
National Institutes of Health
http://www.nlm.nih.gov/medlineplus/bellspalsy.shtml

National Institute of Neurological Disorders and Stroke
National Institutes of Health Neurological Institute
PO Box 5801
Bethesda, MD 20824
800-352-9424
http://www.ninds.nih.gov/health_and_medical/disorders/bells_doc.shtml

National Organization for Rare Disorders
PO Box 1968
Danbury, CT 06813-1968
203-744-0100
http://www.rarediseases.org

This information is not a substitute for medical treatment.

Please send technical questions related to the Web site to Ann Harste