2-Minute Neuroscience: Bell's Palsy

Bell’s palsy is a disorder characterized by facial weakness or paralysis, typically on one side of the face. It results from the dysfunction of cranial nerve VII, the facial nerve, but the cause of the facial nerve dysfunction is unknown. In this video, I discuss the symptoms, possible causes, and prognosis for Bell’s palsy.

TRANSCRIPT:
Bell’s palsy is a disorder that results from the dysfunction of cranial nerve VII, the facial nerve. It involves weakness or paralysis, typically on one side of the face. The onset of the condition is rapid, usually progressing to maximum severity within 72 hours. While there can be a number of causes of facial weakness or paralysis, the cause of Bell’s palsy is unknown, and diagnosis is made by ruling out other potential causes like Lyme disease, trauma, tumors, etc. In other words, Bell’s palsy is only diagnosed when there is not another identifiable cause of the facial paralysis.

The symptoms of Bell’s palsy can vary from case to case in both form and severity, but the most common symptom is rapidly developing weakness on one side of the face. There can be a number of other symptoms that emerge from facial nerve dysfunction, including drooping of the eyelid, drooping of one side of the mouth, drooling, an inability to completely close the eye, excessive tearing and pain in the eye, facial pain, loss of taste, hypersensitivity to sound on the affected side, and other symptoms depending on the case.

Although the cause of Bell’s palsy is unclear, there is evidence that many cases may have a viral origin. Reactivation of latent viruses such as the herpes simplex virus has been hypothesized to be an important factor in many cases of Bell’s palsy, but how exactly viruses might damage the facial nerve is still uncertain. Other factors potentially involved in the development of Bell’s palsy include reduced blood supply to the facial nerve and damage to the facial nerve caused by inflammation. Most cases of Bell’s palsy start to improve without any medical intervention within a few weeks, and recover completely within 3 to 4 months. Less commonly, symptoms may last longer, never completely disappear, or fade away and then reoccur.

REFERENCES:
Baugh RF, Basura GJ, Ishii LE, Schwartz SR, Drumheller CM, Burkholder R, Deckard NA, Dawson C, Driscoll C, Gillespie MB, Gurgel RK, Halperin J, Khalid AN, Kumar KA, Micco A, Munsell D, Rosenbaum S, Vaughan W. Clinical practice guideline: Bell's palsy. Otolaryngol Head Neck Surg. 2013 Nov;149(3 Suppl):S1-27. doi: 10.1177/0194599813505967. PMID: 24189771.


Reich SG. Bell's Palsy. Continuum (Minneap Minn). 2017 Apr;23(2, Selected Topics in Outpatient Neurology):447-466. doi: 10.1212/CON.0000000000000447. PMID: 28375913.

Zhang W, Xu L, Luo T, Wu F, Zhao B, Li X. The etiology of Bell's palsy: a review. J Neurol. 2020 Jul;267(7):1896-1905. doi: 10.1007/s00415-019-09282-4. Epub 2019 Mar 28. PMID: 30923934; PMCID: PMC7320932.

[JeanStAubin-nluo]

I had Bell's Palsy on the left side of my face in 2014 and on the right side of my face in 2017. The first time I had it, it lasted 10 months. It was very embarrassing because people kept asking if I had a stroke. It was hard to speak perfectly with my mouth in a weird position. My eye was droopy and ran all the time. The second time I got it, it lasted 6 months. What really had me worried the first time was that everything I read from doctors had said it would go away within six weeks. I was so afraid that mine would never go away and that I would be stuck like that for life. At the time I was working a full time job and a part time job. Today I am fine. I don't have a huge smile but at least my lips aren't droopy. My eyes do run all the time and no one can tell me why but then I guess that's not the worse thing. Just wanted to let people who have this know that it can take a LONG TIME to get rid of this. Don't lose hope.

[dantemarcos]

I pray full recovery to every Bell’s palsy patient here 🙏🙏

[gloriamesa]

I was diagnosed with bells palsy, it's my day 9 now and every day there is progression. I've had acupuncture, facial massages, facial exercises and steroid.The only problem for me now is the excessive teary eyes and I couldn't close the left eye completely. Had to wear mask and eye glasses to prevent it.I know it takes time to recover 😢I am patient and I will not lose hope.I just want to let you know that you are not alone.

[ddnoprt]

Had this in high school out of no where.

Was so confused but my friends and I just laughed so hard. My girlfriend and mom freaked out and made me go to the doctor… he said Bell’s palsy, if it doesn’t go away in a month he will recommend a nerve doctor.

Went away in about two weeks.

[mattchu_caleb]

I swear the comment section of this video is like a Bell’s palsy club 12 Days In myself no recovery yet but reading a lot of these comments have given me hope..

[Ai_.editzz-Yt]

Man this is my 3rd time having this I first got it in 2015 then 2017 and now I got it 7/23/22 :( hopefully I get a full recovery I’ll keep y’all updated stay safe. Update: Recovery happened on august 15 (23 days later) i actually felt some process coming in 2-3 days before it fully recovered and I took no medicine and didn’t go to the hospital

[MsSomeKT]

I had bells palsy for the first time when I was about 15 or 16 years old in the early 2000s. I recall it clearing up in a few weeks and needing to take tons of meds. I had it for the second time during my first pregnancy and again remember it lasting a few weeks. I don't remember my doctor prescribing me anything. I am currently dealing with it again at 37 years old. This time I am noticing more pain on the side of my face impacted. It started with a weird headache at the base of my skull/neck. Lasted for 3 days and on day two I started noticing my taste was weird and almost felt like my mouth was novacained without the puffy feeling but also while still able to feel my face when I touch it. Its a strange feeling. I am also VERY sensitive to some sounds. I have NEVER been noise sensitive.

Not sure if it is relavent but, my family also just recovered from influenza about 2 weeks ago.

To anyone currently dealing with this, now or in the future please know you are not alone and a stranger on the internet is sending you all the love and healing vibes. 💜

[taiguy]

My dad got this just 3 days ago. At first, he had trouble moving some areas of his right face, such as closing his eye completely and controlling his right half of his lips. It made eating a little hard with food and water constantly spilling out and water would go in his eye while showering. And just today, he lost complete movement of his right face, and it's an obvious droop.
I didn't hear of Bell's Palsy until I overheard a doctor diagnosing my dad over video call. I could sense his fear when the doctor said there's a chance this would be permanent.

My dad has never gotten any serious health issues or had any bad health experiences. He's been very healthy. He always watches what he eats and how much, and eats junk food occasionally, sometimes rarely. He always talks about how old he is. He's in his late 30's and with this condition, it's probably imprinted in his mind that he's already too old, despite how much I try to convince him otherwise. He's scared to the point where he wants to avoid junk food all together, and wanting to eat more fruits and vegetables and less fatty meats and foods. I'm not as scared as my dad is, but scared for him regardless. All I can do is hope that it's not permanent, so that I can see a full smile from him again.

[michellemojicabronson]

I was diagnosed with Bell’s palsy about 6 weeks ago. I went to urgent care as soon as I saw my first symptom. Headaches were so strong only on half of my head, suddenly, I could not eat, chew, speak, blink, taste anything or brush my teeth.
The doctors prescribed antiviral and prednisone which I had for about 10 days.
I also was referred to a neurologist and to an ophthalmologist as I could not close my eyelid. Neurologist prescribed more anti inflammatory (prednisone) another 6 days. Also, I got a doctor’s note to take time off to rest for about 3 weeks.
After 3 weeks I started seeing improvements but my face fully recovered after 5 weeks.

Good luck to anyone who is dealing with this serious condition. Go to see a doctor soon and rest!

[MarkWendland]

My wife noticed some early symptoms, was diagnosed in the afternoon and by the evening and next morning her face was completely impacted. Very clearly related to severe lack of sleep and stress in her case. CAT scan ruled out some other possibilities. They put her on steroids. We are just in the first days of it, and it is both annoying and scary. Thank you to those of you who have shared your experience.

[nyloaf]

Ive got bells palsy, and luckily we got steroids to treat it within 24h of it occurring. I had to do weird exercises where i continually smile, frown, blink, etc multiple times a day. I had to wear an eye patch at night while i slept to avoid damaging my eye since it wouldnt close, and it lasted more noticeably for about a month.

I was very lucky and got treated for it quickly, after noticing that my right eye stopped blinking when my left did. The next day, i lost the ability to move the right side of my mouth at all. I remember it being painless, however, when i would sleep on my right side i had to rest my face gently because i had a strange pain in my jaw near my ear when i leaned too hard onto the right side of my face. It took at least a few months for that pain to go away fully.

Ive been told theres no real idea of why it occurs, but that it can have something to do with things like lupus or other similar diseases and that even after going away, its been known to reoccur. I myself dont have an immune disease like lupus, but my mom does

It was very strange to experience it to be honest, it felt like the muscles on the right side of my face completely atrophied and couldnt move at all

[taydertauht]

I had bell’s palsy around 2013/2014 that started from some kind of outer ear infection. One day my ear canal was red and itchy and a little swollen, and within a day or two it straight up looked like cauliflower ear. It was probably around 12 hours after that that I realized my left eye wasn’t blinking fully and I couldn’t “catch my bubble” (meaning holding air in my mouth/cheeks) because I couldn’t purse the left side of my lips.

I went to the ER, they said I looked fine, and I spent the next month with half my face paralyzed. It was Christmas so I got asked to smile for pictures and my bf’s (at the time) sister laughed at me asking why I was smiling like a ninja turtle.

It’s funny now but it fkn sucked then not knowing if it was going to be permanent. I had to tape my eyelid down bc after the first night I woke up with my eye scarily dry and scratched.

I believe that the swelling was caused by hsv even though it never presented itself in that way before or since. And maybe it was the virus itself that affected the facial nerve or the swelling from my ear pushing down on it.

But if anyone experiences similar symptoms, demand viral testing for HSV and antivirals as soon as you can. My face was paralyzed for a month.

[ArthurShelby-PB]

I recovered fully from Bell's Palsy within a month and a half, I'm so happy it's gone. I had all symptoms except from drooping, there was zero drooping anywhere.

[ciaradeaney]

thank you for this informative video, my disabled father just got this and I've been worried sick about him. this genuinely gives me more information than the doctors

[lynn]

Here I am again. Part 2.
I legit had this 5-6 years ago 2017. I can’t e member my recovery time unfortunately from the first round about. I got it agin this year 9/11/2023. Past one week now. Doing facial exercises . Taking B12 and potassium.

Finished my first round of steroids.
Only this time I learned that I get anxious because I cannot pronounce things and I work at a call center. First week was so rough. I literally had a panic attack every 4 hours.
Had to cope with the best way I know. Laughter making myself a living joke. Telling my coworkers and brining a smile to their lovely faces. This condition is rather tedious . I literally recovered two weeks ago also from a UTI and taking my antibiotics. Have to keep my faith up and remind myself that I am blessed with each living breath and this is just another trail I am facing.

I pray for everyone that has this condition -
You find peace, during this storm and have faith you will recover your beautiful smile.
I pray you don’t lose faith and you find understand on how to continue to praise the lord in times of toughness and remember that God is with you - especially in these trials. ♥️😭

[shelovinthecrew]

Legit got this so randomly happened overnight

[mariussefu]

iv had it on my left. and now is starting identical symptoms (starting with pain behind the ear then loss of taste on one side of the tongue then eye dripping and the muscle weakness) on the right side. hope for a fast recovery like last time (1-2 weeks)

[yhqyoyj]

I had this when I was 8/9. I took physiotherapy and facial massages and lots of facial exercises. It was improved after 1/2 months

[kamikaze_Granny]

Hi doc, first of all I want to thank you for all your efforts of helping us all. My question is this... About 4 months ago, I was diagnosed with Bell's Palsy. The doctor prescribed a facial physiotherapy and daily dose of Prednisone ( Ephasol ). I took it for 2 weeks and 2 days (40 mg for a week, 20 mg for 5 days and 10mg for the last 4 days). I can now say the Bell's Palsy has been treated and my facial paralysis has gone. But I started seeing different symptoms on my body. 1. Exactly after a week of taking the medication I started hearing my heartbeat through my ears. 2. After about a month of stopping the med my right hand finger knuckles got dark and my body started shaking (slight shaking of sometimes the legs, sometimes the arms and a throbbing feeling in the back of my head). 3. Ringing ears (most noticeably in 1 ear) started 2 weeks ago. 4. A tight feeling in my forehead. Doc, are these the side effects of the medication? What is the solution?

[brainsbreaks]

Got this yesterday. Follow my story but i was on FaceTime with a friend when he notice my face was droopy and my eye was twitching. The whole right side of my face can’t move. Taking meds right now but all the story helps. Hope i can recover quick . A friend said his gf healthy etc and had it for like ten years