Bell's palsy

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Ptosis, drooping of the eyelid

Bell's palsy

Alternative Names:

Facial palsy
Symptoms:

Pain
- Behind ear
- In front of ear
- May precede weakness of facial muscles by 1-2 days
Loss of sense of taste
Sensitivity to sound (hyperacusis) on the affected side
Headache
Face feels stiff
Face feels pulled to one side
Difficulty with eating and drinking
Change in facial appearance
- Facial droop
- Difficulty with facial expressions, grimacing
Facial paralysis of one side of the face
- Difficulty closing one eye
- Difficulty with fine facial movements
Drooling due to inability to control facial muscles
Dry eye secondary to being unable to close eye properly because of facial weakness

Signs and tests:

text continues below

Examination shows upper and lower facial weakness, which is almost always isolated to one side of the face or occasionally to the forehead, eyelid, or mouth. Despite a patient reporting feeling sensory symptoms, the loss of sensation on examination is a rare and disturbing finding. Blood pressure is normal. If there are no other abnormalities on examination, no imaging studies are usually done.

Blood tests for sarcoidosis or Lyme disease may be considered under some circumstances. If there is no improvement in the facial paralysis after several weeks, an MRI is done to rule out other causes of the dysfunction. An EMG and nerve conduction studies may also be done to determine the severity of nerve damage.