Bells Palsy

Diagnosis

Your doctor usually will be able to diagnose Bell's palsy based on a physical examination. He or she will test for weakness in the muscles of the face, paying special attention to your ability to close both eyes and hold them closed. He or she also will ask you to smile or whistle to look for a difference on the two sides of your face. Your doctor will ask whether you are having any symptoms of numbness or weakness in other body parts or difficulty walking. These symptoms are not a part of associated with Bell's palsy, but this will help to rule out other causes of facial weakness.

Your doctor will look for a shingles like rash on your face and ear. The presence of this rash, especially with pain, is diagnostic of Ramsay-Hunt syndrome caused by reactivation of the herpes zoster virus.

If there are no other symptoms, and the problems are only related to weakness of facial muscles, then your doctor can diagnose Bell's palsy without further testing. A blood sugar test may be ordered if you have not had one recently, because people with diabetes are at higher risk for Bell’s palsy. A blood test for Lyme disease also may be done.

Expected Duration

Most people’s symptoms peak at 48 hours, start to improve by 2 weeks, and they are back to normal by 6 months. In rare cases, the symptoms do not go away completely and there is some permanent facial weakness.