Bell's Palsy Symptoms & Risk Factors

Bell’s Palsy 101: Symptoms, Causes, Diagnosis & Management

Bell's Palsy is a type of facial paralysis caused by a temporary weakness in the face muscles. Learn more about its causes, how it’s different from a stroke and the treatments available.

by Katherine Khaw

What is Bell’s Palsy?

A condition named after Scottish anatomist Charles Bell describes the temporary weakness or paralysis of the muscles in the face. This is marked by a visible lopsided or droopy appearance on one side of the face, paired with an inability to close or open the affected eye.

While it is termed an unexplained episode, it is an occurrence that gradually worsens over 48 hours (John Hopkins Medicine, 2022). It is not considered a permanent condition, but in rare cases, it may afflict the person for life. In sporadic cases, a person may experience this condition recurrently.

Symptoms of Bell’s Palsy

These are the common signs and symptoms of Bell’s palsy to look out for:

  • Weakness of the facial structure, such as the loss of feeling in the face
  • Lessened ability to control the movement of facial muscles, such as smiling, squinting, blinking or closing your eyes
  • Loss of sense of taste
  • Increased hearing sensitivity to noises in the affected ear
  • Pain around the jaw or around the ear for the affected side
  • Changes to the amount of saliva and tears produced (i.e. may cause drooling or tearing)
  • Headaches

In isolated cases, Bell’s palsy may affect both sides of the face. It usually interferes with one side of the face. These symptoms may develop 1-2 weeks after having a cold, ear infection or eye infection.

Bell’s Palsy vs. Stroke

Oftentimes, a person would take a droopy appearance as an onset of stroke. However, Bell’s palsy and stroke have significant differences.

Age Factor

Typically, Bell’s palsy is most likely to afflict persons of age 15-60. It is less common before 15 or after 60 years old. Meanwhile, the danger of stroke is likely to be found in persons aged 60 and above.

Time Taken

Bell’s palsy would require a timeline of at least a few hours, up to a few days (i.e. gradual in exhibiting symptoms). Whereas a stroke episode would only require seconds to minutes to manifest fully.

Face Paralysis/Droopiness

Bell’s palsy will affect the entire face, only differing in terms of severity. For strokes, while the lower face is always affected, the upper face may or may not be.

Overall Symptoms

Bell’s palsy symptoms have been elaborated in the previous section. Aside from the inconvenience, it is rarely as troublesome as experiencing a stroke. Stroke’s associated symptoms are as follows: weakness, numbness, speech difficulty or slurred speech, double vision phenomenon, difficulty in swallowing, vertigo and ataxia. A person with a stroke usually cannot lift up both arms and keep them in a heightened position.

Typically, a medical authority would be able to identify which of the conditions is being exhibited with the following means:

  • Receiving information from the patient (to estimate the time taken for the condition to manifest)
  • Performing a brief neurologic exam (checking the condition of the mouth, eyes and forehead)
  • Confirming the onset symptoms
Caution: If you know someone who is experiencing signs of a stroke, it is necessary to get a medical authority to confirm it immediately and get treated. Persons with Bell’s palsy do not suffer from the same urgency and are not placed in a life-threatening situation.

Causes of Bell’s Palsy

At the time of writing, researchers have been unable to pinpoint the reasons why Bell’s palsy occurs. In fact, there is no known way to prevent Bell’s palsy. Researchers have opined, nonetheless, that it may be a result of inflammation that infects the nerve controlling movement of the face, causing paralysis.

Here are some of the possible causes of Bell’s palsy as listed:

  • Diabetes
  • High blood pressure
  • Injuries
  • Toxins
  • Lyme disease
  • Guillain-Barré syndrome
  • Multiple sclerosis
  • Virus infections (e.g. cold sores, genital herpes, chickenpox, shingles, german measles, mumps, and more)

Risk Factors of Bell’s Palsy

While the causes of Bell’s palsy remain mostly unknown at large, this condition is generally more likely to affect the following groups of people:

  • Pregnant women
  • People with diabetes
  • People with an upper respiratory infection (i.e. flu, cold, lung infection)
  • Family history of the condition (e.g. persons who had it before, had recurrent episodes)

Diagnosing Bell’s Palsy

After experiencing the symptoms of Bell’s palsy, it is vital to check your status with the local healthcare provider. Treatment for Bell’s palsy is more effective if it is done within the immediate 72 hours.

There is no specific lab test to diagnose this condition. Nevertheless, the doctor can arrange for several tests in order to rule out other diseases that may exhibit similar symptoms. These tests can also determine the nerve damage incurred within your body.

Tests that you may expect from your healthcare provider:

  • Blood tests to check for any ongoing bacterial or viral infection
  • Blood tests to check any underlying conditions, such as diabetes
  • Imaging tests to assess the nerves in your face and rule out the diagnosis of a stroke or brain tumour, via an MRI or CT scan
  • An electromyography (EMG) test to determine the amount of damage to the nerves that control the facial muscles
  • Lumbar puncture, if Lyme disease is considered

Treating Bell’s Palsy

What’s next after your diagnosis is to receive the appropriate treatment. Depending on what was the root cause that triggered the condition, the treatment will be specified accordingly.

Generally, the eye will be treated for persons experiencing Bell’s palsy. This is due to the weakened ability to blink or close one’s eyelid. Some of these may be advised for you:

  • Eye drops to ensure that the affected eye is sufficiently lubricated
  • An eye patch to cover the dry eye, especially during the night time when you are asleep
  • Moisture chamber to slow the evaporation of tears

These steps are taken in order to protect the cornea from being scratched or injured, as the eyelid is unable to close.

Aside from these, the doctor may recommend medications such as these:

  • Steroids to reduce inflammation
  • Antibacterial or antiviral medication, if required
  • Analgesics or over-the-counter pain medications to alleviate pain

Physical therapy exercises may also be prescribed to stimulate the facial nerves. Simple home remedies such as placing a warm, moist towel over your face can help you to relax, along with a facial massage.

Some people may consider alternative therapies in treating Bell’s palsy, but there is no conclusive evidence that these make a difference in the recovery process. Among which are:

  • Relaxation practices
  • Acupuncture
  • Electrical stimulation
  • Biofeedback training
  • Vitamin therapy

Bell’s Palsy Recovery & Management

Bell’s palsy is mostly a temporary condition. After diagnosing the condition, your healthcare provider can prescribe the necessary medication and procedures. 85 per cent of individuals with Bell’s palsy indicate clinical improvement within three weeks of treatment, eventually recovering normal facial function.

For some, there may be mild effects of the condition after recovery, such as the occasional facial weakness. There may also be consequences of involuntary mouth or eye movements.

With regards to the recovery process, these are the frequent advice given to manage the situation:

Take a lot of rest. It is important to get enough sleep and avoid heavy physical activities. During sleep, research has demonstrated that the cardiovascular and immune systems are boosted, helping to regulate metabolism. It is preferred to carry out jobs in stages post-recovery.

Protect your eye from drying. Be sure to keep it well lubricated with eye drops and patch it during the night. Wear glasses or sunglasses to protect the cornea from wind and dust. Otherwise, you may suffer from a significant case of dry eye, namely exposure keratitis.

Perform gentle massages. Carry out a comfortable massage of your face, neck and head area at least twice a day. You can add massage oil so that your skin would not be too tense. Massaging would improve blood and lymph circulation, increasing the speed of nerve regeneration.

Practice patience. It would not be wise to be stressed out about your prognosis or progress. Depending on how severe one’s nerve damage is, it may take up to 2-3 months before seeing returns of facial movement. Medication cannot speed up this process of recovery. Therefore, it is vital for the body to be in the healthiest state possible at that time. It may also be distressing as it interrupts facial expression, speaking, eating, sleeping and other lifestyle activities.

Using a straw. A droopy mouth may make room for messes and embarrassment when trying to drink from a glass. Using a straw would decrease the chances of dribbling a beverage down your chin. This would reduce stress during mealtimes and stay hydrated.

Talking to someone. Mental and emotional health is also important to your recovery. Having a temporal paralysed face may cause insecurities about how you look. Share your feelings with a trusted friend or family. You can also look for a counsellor or therapist to express your emotions.

When to See a Doctor

If you experience droopiness or paralysis of the face, get in touch with your doctor. This is to ensure that you can start your treatment early and improve recovery rates. Be sure to check with a neurologist who is able to diagnose and confirm the condition. It is best to record when it started happening, along with some photographic evidence, to smoothen the diagnosis process.

Are you looking for someone to care for your loved ones living with Bell’s Palsy?

Homage provides caregiving services for your loved ones at every stage. Our trained Care Professionals are able to provide companionship, nursing care, night caregiving, home therapy and more, to keep your loved ones active and engaged.

Provide the best care to your loved one today! Fill up the form below for a free consultation with our Care Advisory team.

Fill out the details below and our Care Advisors can get back to you with the care information you need.

  1. John Hopkins Medicine (2022). Bell’s Palsy [Website]. Retrieved 28 February 2022, from .
  2. Khan, A. & Larson, J. (2021). What Is Bell’s Palsy? [Article]. Retrieved 28 February 2022, from .
  3. Mayo Clinic (2022). Bell’s palsy [Website]. Retrieved 28 February 2022, from .
  4. Mullen, M.T. & Loomis, C. (2014). Differentiating Facial Weakness Caused by Bell’s Palsy vs. Acute Stroke [Article]. Retrieved 28 February 2022, from .
  5. National Institute of Neurological Disorders and Stroke (2021). Bell’s Palsy Fact Sheet [Website]. Retrieved 1 March 2022, from .
  6. Pashov, A. (2022). Seven steps towards recovery from acute Bell’s Palsy [Article]. Retrieved 1 March 2022, from .
  7. Suni, E. (2020). What Happens When You Sleep? [Website]. Retrieved 1 March 2022, from .
About the Writer
Katherine Khaw
Katherine is an avid reader, finding joy in halls of words. Aside from the imagination wandering in worlds not here, she enjoys stargazing and gardening. In her heart of hearts, she aspires to be a writer, and to be more than mere dust.
Make Home Care Personal To Your Loved One

Make Home Care Personal To Your Loved One

Get started with a free consultation today, and learn why thousands of Malaysians trust Homage to deliver the best care in their homes.

Get Care Now