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Bell's Palsy: Treatment, Procedure, Cost and Side Effects

Last Updated: Feb 21, 2023

What is the treatment?

Bell’s palsy is a condition in which one half of the face droops due to muscle weakness. It may be a reaction to a viral infection. It is generally seen to occur in pregnant women and people with respiratory problem diabetes. You must look out for signs like facial droop, difficulty in making facial expressions like closing your eyes or smiling, decrease in your ability to taste, changes in the amount of tears and saliva you produce and pain around the jaw or behind the ear. You must consult a doctor as soon as you see signs of paralysis. Most of the time, bell’s palsy resolves on its own within six months. However, treatment will help you recover sooner. In rare cases, it can affect nerves on both sides of your face.

Is Bell's Palsy the same as a stroke?

Both of the conditions cause facial paralysis, which can be described as drooping one side of the face. The difference is the damage they cause to the body.

During a stroke, blood flow is being stopped and manipulated by big blood clots. Facial nerves do not get affected to an extent that they get damaged. On the other hand, Bell's Palsy causes inflammation in the facial nerves leading to damage to the muscles.

The good news is in both of the cases the paralysis can be cured.

Summary: Even though the symptoms of a stroke and bell’s palsy are the same, they are very different in their physical damage. A stroke is more serious and damaging than drooping of one side of the face.

How is Bell's Palsy transmitted?

The disease itself is not contagious. Face paralysis does not get spread by direct or indirect contact, however, if the cause of Bell's Palsy is associated with viral infections, the possibility to spread the virus is quite high.

Since Bell's Palsy is only one of the symptoms of viral diseases, it is not confirmed that its spread will also cause the same effects.

Here is the list of viral infections that may cause face paralysis:

  • Cytomegalovirus (CMV)
  • Herpes simplex virus 1 (HSV-1)
  • Measles
  • Varicella zoster virus (VZV)
  • Mumps
  • Epstein-Barr virus (EBV)
  • Adenovirus

What is the main cause of Bell's Palsy?

The main reason why bell palsy happens is still under the shades, yet there are some assumptions that doctors made which may be behind cranial nerve inflammation:

  • Viral infections
  • Immunity manipulation due to stress or sleeplessness
  • Physical trauma or illness
  • Autoimmune syndrome
  • Brain tumour
  • Stroke
  • Lyme disease
  • Myasthenia gravis

Any of these affect an individual's facial nerves or myelin sheath to swell which restricts blood and oxygen in the fallopian canal.

Summary: The root cause of Bell's Palsy is still under the shade, yet some assumptions have been made by medical professionals which may be behind cranial nerve inflammation.

Does Bells palsy go away?

Yes, even though the root cause of the disease is still unknown, it is considered a temporary condition. It is rare for Bell's Palsy to stay for too long.

As per the recovery, it usually shows its effects within 6 months or at minimum two weeks. The patient mostly recovers all the damage, facial expressions, and strength.

Summary: Bell’s palsy is a temporary condition that goes away on its own. However, the recovery period of the disease is quite flexible and the reason behind the same is still unknown.

Should I go to ER for Bell's Palsy?

Yes, since the resemblance of symptoms is identical to stroke it can be hard to identify when occurred. Seek medical help to ensure the cause of facial paralysis.

Even though Bell's Palsy can heal without any medical aid, in rare cases it may not. So if you find anyone with sudden half-face drooping, consult your doctor immediately.

Summary: To have an accurate diagnosis and treatment plan it is important to have a proper medical consultation. In the case of Bell's Palsy, one must visit ER to have an accurate diagnosis.

How is the treatment done?

The doctor will identify bell’s palsy by observing the movement of your facial muscles like lifting your brows, closing your eyes and frowning. In some cases, you may be asked to go for tests like electromyography (EMG) and imaging scans. EMG can confirm the presence and severity of nerve damage. Imaging scan are done to rule out other sources of pressure on the facial nerve. It can be treated by medications like corticosteroids and anti viral drugs. Corticosteroids are anti inflammatory agents that help in reducing the swelling of the facial nerve. They should be started within a few days of the appearance of these signs to achieve the best results. Physio therapy is recommended for every one going through bell’s palsy as the paralysed muscles may shrink and shorten causing permanent contractures. Physio therapist will suggest ways to exercise your facial muscles to avoid this from happening. In rare cases, plastic surgery may have to be done to correct facial nerve problems.

Who is eligible for the treatment? (When is the treatment done?)

If you are experiencing facial droop, difficulty in making facial expressions like closing your eyes or smiling, decrease in your ability to taste, changes in the amount of tears and saliva you produce and pain around the jaw or behind the ear; you must consult a doctor as these are some signs of bell’s palsy.

Who is not eligible for the treatment?

Decrease in ability to taste and pain around the jaw or behind the ear may occur due to any other medical treatment you are going through. Consult a doctor to confirm your condition.

Are there any side effects?

You may experience temporary rashes and redness in the skin due to certain medications. Other than that, there are no known side effects.

Does Bell's Palsy affect speech?

Yes, due to facial paralysis, one may find it difficult to speak. This condition is known as dysarthria. It occurs when facial muscles, especially the ones responsible for our speaking skills become weak and out of control. Dysarthria during Bell's Palsy also developed oral complications like:

  • Monotone speech.
  • Strained voice.
  • Slurred speech.
  • Slow speech.
  • The uncontrollable volume of the voice.
  • Unable to move the tongue, facial muscles, and lips.
  • Abnormal speech rhythm.
Summary: Most of the disease that affects your facial muscles results in affecting your oral skills. In the case of bell’s palsy, one may experience the difficulty of speech as one of the key symptoms.

What are the post-treatment guidelines?

Protect the affected eye by wearing an eye patch or goggles. Use lubricating drops during the day and eye ointment at night to keep your eye moist and protected. You may take over the counter pain relievers like aspirin, ibuprofen and acetaminophen if the pain goes beyond your tolerance level. Follow your therapist’s advice and exercise your facial muscles regularly to achieve faster results.

How long does it take to recover?

Most of the time, bell’s palsy resolves on its own within six months. Treatment will speed up the results.

How Long Can Bell's Palsy last?

Since the effects of this medical condition are temporary, its side effects may fade away eventually within three months, which may start its effects in the initial two weeks.

In case facial abnormalities take more than usual to heal, it means that there are some underlying complications that were present which triggered face paralysis.

Summary: The duration of the recovery period may vary in each case. From two weeks to six months it can happen anytime.

What is the price of the treatment in India?

One session of consultation with your doctor may cost between ₹600 - ₹1300. The cost of corticosteroids will be around ₹400. The cost of surgery will vary according to the severity of your condition.

Are the results of the treatment permanent?

Bell’s palsy rarely occurs more than once.

What are the alternatives to the treatment?

Most people with bell’s palsy recover fully with or without treatment. You can wait for that to happen naturally without going through any treatment.

Summary: Bell's Palsy can be described as facial muscles weakness or paralysis for a short period of time. The actual cause that triggers the paralysis is still unknown yet doctors manage to find some medical complications that may be behind the facial abnormality. In most cases, it's not an emergency, however, it is advisable to seek immediate medical help as droopiness can also be caused by a stroke.


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Written ByDr. Arun Sharma MBBS,MS - General Surgery,MCh - Neuro SurgeryNeurology
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