You Wanted to Know: Bell’s Palsy

Woman look at herself bathroom mirror reflection

Bell’s palsy occurs when the facial nerve becomes damaged, leading to paralysis of half of the face. This condition comes on suddenly, can strike anyone and affects up to 40,000 Americans every year.

Inflammation, swelling or compression of the facial nerve is responsible for the symptoms of Bell’s palsy. Viruses, particularly herpes simplex virus I (which causes cold sores) and herpes zoster (which causes chicken pox and shingles), are thought to be a common culprit, but the exact cause is not known. One of our viewers, Johnnie, has struggled with this distressing condition multiple times:


Bell’s palsy usually comes on rapidly and may progress from mild weakness to complete paralysis within 48 hours. Symptoms, which vary in severity, include twitching, weakness or paralysis of the muscles on one side of the face (very rarely, both sides may be affected), drooping of the eyelid and the corner of the mouth, drooling, eye dryness or excessive tearing in one eye and trouble tasting. Less common symptoms include jaw pain, ringing in the ears, headache, hypersensitivity to sound on the affected side, trouble speaking and dizziness. Since many of these symptoms can overlap with a stroke or other life-threatening problems, people experiencing these problems should always seek medical attention immediately.

Johnnie, I’m sorry to hear that you’ve had to deal with this uncomfortable problem – especially more than once. Recurrences of Bell’s palsy are actually relatively uncommon and second attacks occur in about 7 to 15% of patients. Fortunately, third attacks occur in only about 3% of people, and fourth attacks in only 1.5%. Some studies suggest that people who suffer from multiple episodes of Bell’s palsy may have a genetic predisposition for it, but this has not been definitively proven. I sincerely hope this attack will be your last.

Unfortunately, nothing has been shown to be effective at preventing recurrent attacks of Bell’s palsy. Factors that have been associated with this condition, however, include diabetes, autoimmune disorders, infection with certain viruses (including HIV, some herpes viruses and the flu), chemotherapy, pregnancy, smoking and high blood pressure.

*The good news is that Bell’s palsy usually has a positive prognosis, with or without treatment, and symptoms often resolve rapidly. In one study of over 1,000 patients, 85% of people showed signs of recovery within three weeks. For most people, entirely normal function generally returns within three to six months, but the time to recovery depends on the severity of the nerve damage. A small percentage of people may have lasting or permanent impairment.