Bell’s Palsy

The exact cause of Bell's palsy is not fully understood, but it’s believed to be primarily related to inflammation and swelling of the facial nerve, which is the seventh cranial nerve responsible for controlling the muscles of facial expression. This inflammation is thought to result from the activation of the body's immune system in response to viral infections.

Several viruses have been associated with the development of Bell's palsy, with the most common being the herpes simplex virus (HSV). This is the same virus responsible for cold sores and genital herpes. It’s believed that the herpes simplex virus, typically the type 1 strain (HSV-1), becomes reactivated in the facial nerve, leading to nerve inflammation and subsequent facial weakness or paralysis.

In addition to HSV, the varicella-zoster virus (VZV), which causes chickenpox and shingles, has also been implicated in some cases of Bell's palsy. Other viruses that have been linked to Bell's palsy include the Epstein-Barr virus (EBV) and the cytomegalovirus (CMV).

While viral infections are considered the most likely trigger, other factors may contribute to the development of Bell's palsy, including:

• immune system disorders: certain immune system disorders or abnormalities may increase the likelihood of facial nerve inflammation

• genetics: there may be a genetic predisposition to developing Bell's palsy in some individuals

• environmental factors: exposure to environmental factors or toxins could potentially play a role in some cases

• pregnancy: pregnant women, especially during the third trimester and in the immediate postpartum period, may have a slightly higher risk of developing Bell's palsy

It's important to note that while viral infections are common triggers, having an infection with one of these viruses does not necessarily mean you will develop Bell's palsy. The condition is relatively rare, and most people who contract these viruses do not experience facial paralysis.

As Bell's palsy shares symptoms with other conditions affecting the facial nerves or structures, it’s important to see a neurologist for an accurate diagnosis. 

Your Welbeck consultant will conduct a physical examination and may perform additional tests, such as MRI or CT scans, to rule out other potential causes of facial paralysis and confirm the diagnosis of Bell's palsy. Early diagnosis and treatment are essential for optimal recovery.

Because the exact cause of Bell’s palsy is not fully understood, there’s no guaranteed way to prevent it. However, certain steps may help lower your general risk of nerve inflammation or viral triggers, including:

• maintaining a healthy immune system through a balanced diet, regular exercise, and good sleep

• managing stress effectively, as high stress levels can weaken immune defences

• avoiding or treating viral infections promptly, such as cold sores or flu, which may be linked to Bell’s palsy

Most people recover fully from Bell’s palsy within weeks to months, but in some cases, side effects or complications can occur, such as:

• incomplete recovery – some weakness or asymmetry of facial muscles may persist
• abnormal nerve regrowth – leading to involuntary movements, such as eye closure when smiling (synkinesis)
• eye problems – difficulty blinking can cause dry eye, irritation, or corneal damage
• chronic facial pain or twitching – in rare cases, discomfort or spasms can continue long-term
• psychological and social impact – changes in facial appearance or speech may affect your confidence and emotional wellbeing

The treatment of Bell's palsy aims to reduce inflammation of the facial nerve, manage symptoms, and promote recovery. Most cases of Bell's palsy resolve spontaneously over time, and the majority of individuals experience full recovery without treatment.

However, certain interventions may help speed up recovery and alleviate symptoms. The treatment options include:

• corticosteroids: oral corticosteroids are often prescribed to reduce inflammation and swelling of the facial nerve. These medications are most effective when started within the first 72 hours of symptom onset. Corticosteroids are commonly used to improve the chances of recovery and reduce the severity of facial paralysis

• antiviral medications: while the role of antiviral medications in Bell's palsy treatment is still debated, some doctors may prescribe them in combination with corticosteroids, especially if there is a suspected viral trigger. Antiviral drugs may help if the palsy is caused by the herpes simplex or varicella-zoster virus

• eye care: protecting the affected eye from dryness and injury is crucial, especially if the ability to close the eyelid is impaired. Using artificial tears and lubricating ointments can help keep the eye moist and prevent complications like corneal abrasions

• physical therapy: facial exercises and physical therapy techniques may help maintain muscle tone and prevent muscle stiffness during the recovery process. A physical therapist or healthcare provider can guide patients on appropriate exercises

• eye patch or tape: in some cases, if the eye cannot fully close, an eye patch or medical tape may be used to keep the eye protected during sleep and reduce the risk of corneal damage

• pain management: over-the-counter pain relievers can help manage any discomfort or pain associated with Bell's palsy

• electrical stimulation: in some instances, electrical stimulation therapy (electromyography biofeedback) may be used to stimulate the facial muscles and improve function

• alternative therapies: some individuals may explore complementary and alternative therapies, such as acupuncture or relaxation techniques, to alleviate symptoms and support recovery. While these approaches may offer some relief, their effectiveness may vary from person to person

It's essential to remember that the effectiveness of treatment can vary depending on the individual and the severity of the condition.

If you suspect you have Bell's palsy or experience sudden facial paralysis, make an appointment for a consultation with a Welbeck neurologist for proper evaluation and management. Early treatment can help improve the chances of a favourable outcome and prevent complications.

At Welbeck, our neurologists are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.

Get in touch today to book an appointment. 

Is Bell’s palsy the same as a stroke?

Although Bell’s palsy and stroke can both cause facial weakness, they are very different conditions. Stroke symptoms tend to appear alongside other problems, such as difficulty speaking, weakness in the arms or legs, or sudden loss of balance, whereas Bell’s palsy usually only affects the facial muscles.

Can stress or fatigue make Bell’s palsy worse?

Stress and tiredness don’t cause Bell’s palsy, but they can make the experience feel more challenging and slow recovery down for some people. Prioritising rest, good nutrition, and manageable routines may help your body heal more effectively.

Is it safe to fly or travel if I have Bell’s palsy?

In most cases, yes. Bell’s palsy itself doesn’t prevent you from flying or travelling. The main consideration is comfort – if one eye doesn’t close fully, you may want to use drops or protective glasses to keep it from drying out during the journey.

Can facial exercises help with recovery from Bell’s palsy?

Yes, gentle, guided facial exercises can support muscle strength and coordination as the nerve heals. A neurologist or a physiotherapist can demonstrate safe exercises tailored to your needs.