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Idiopathic Facial Paralysis (Bell Palsy)

Acute, idiopathic peripheral facial nerve paralysis evolving over 72 hours, presumed to result from inflammatory neuropathy of the seventh cranial nerve, often associated with herpes simplex virus reactivation, with high spontaneous recovery in most patients.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Nöroloji department. Book Appointment →

What is Idiopathic Facial Paralysis (Bell Palsy)?

Bell palsy is the most common cause of unilateral lower motor neuron facial paralysis, accounting for 60 to 75 percent of acute peripheral facial paralysis cases, with annual incidence around 20 to 30 per 100,000.

It is presumed to be due to inflammatory and edematous swelling of the facial nerve in the temporal bone canal, possibly mediated by reactivation of latent herpes simplex virus type 1.

Diagnosis is clinical with rapid onset (less than 72 hours) of unilateral facial weakness involving forehead, with no other neurologic findings, after exclusion of secondary causes by examination and selective imaging.

Symptoms

Acute unilateral facial droop including forehead and eye closure weakness
Inability to wrinkle forehead, close eye fully, or smile on affected side
Postauricular pain preceding or accompanying paralysis
Hyperacusis, altered taste on anterior tongue, decreased tearing or salivation
No other cranial nerve or limb signs distinguishing it from central etiologies

Risk Factors

Recent viral upper respiratory infection
Pregnancy (especially third trimester) and postpartum
Diabetes mellitus and hypertension
Family history of Bell palsy
Immunosuppression or recent emotional or physical stress

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Acute facial weakness developing within 72 hours
  • Inability to close eye exposing cornea to drying and injury
  • Suspected secondary cause — recurrent palsy, slowly progressive, or other deficits
  • Severe ear pain or vesicles suggesting Ramsay Hunt syndrome

Treatment Methods

01
Oral prednisolone 60 mg daily for 5 days then taper, started within 72 hours of onset
02
Antiviral therapy (valacyclovir or acyclovir) added for severe paralysis or suspected zoster sine herpete
03
Eye protection — lubricating drops, ointment at night, taping eyelid, or moisture chamber
04
Facial physiotherapy after acute phase to retrain neuromuscular function
05
Consideration of facial nerve decompression in severe cases with electrical evidence of nerve degeneration > 90 percent within 14 days

Which Department to Visit?

You can visit our Nöroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.