Published June 25, 2023

Understanding Bell's Palsy: Causes, Prognosis and Treatment Options

Bell's palsy is a condition that causes sudden, temporary weakness or paralysis on one side of the face. It is the most common cause of facial paralysis, affecting around 1 in 60 people at some point in their lifetime. While it can occur at any age, Bell's palsy is most common in people between ages 15-45. The good news is that most people fully recover from Bell's palsy, but it's important to understand the condition and get proper treatment to ensure the best outcome.

Bell's palsy

What Causes Bell's Palsy?

The exact cause of Bell's palsy is unknown, but it is believed to be due to inflammation and swelling of the facial nerve that controls facial muscles. This nerve runs through a narrow bone canal from the brainstem to the face, and if it becomes inflamed or compressed, it can cause temporary paralysis.

Some potential causes and risk factors for Bell's palsy include:

Viral infections - Herpes simplex virus, varicella-zoster virus, Epstein-Barr virus and cytomegalovirus may trigger inflammation and swelling.
Autoimmune disorders - Conditions like lupus and rheumatoid arthritis increase risk.
Diabetes - High blood sugar levels can damage nerves.
Pregnancy - Increased risk especially in 3rd trimester.
Family history - Slightly higher risk if a family member has had Bell's palsy.
High blood pressure.
Head trauma.
Exposure to cold.

What is the Prognosis for Bell's Palsy?

The prognosis for Bell’s palsy is generally very good, with most people starting to see improvement within 2 weeks and complete recovery within 3-6 months. However, in a minority of cases, significant residual weakness or paralysis can remain.

Factors that indicate a better prognosis include:

Mild facial weakness at onset
Recovery beginning within 14 days
Complete palsy lasting less than 60 days
No forehead involvement

Poor prognostic factors include:

Total facial paralysis
No recovery signs within 3-4 months
Older age
High blood pressure
Pain around the ear at onset
Recurrent Bell's palsy

Of those with incomplete recovery, about 5-15% experience persistent moderate to severe weakness, synkinesis (involuntary movements) or contractual spasms. Additional treatments may help improve outcomes in these cases.

How is Bell's Palsy Treated by Neurologists?

There are several main treatment approaches for Bell’s palsy:

Medications: Corticosteroids like prednisone are commonly prescribed, especially if started within 72 hours of symptom onset. Antivirals may also be used. These reduce inflammation and may help speed nerve recovery.

Physical Therapy: Facial exercises and massage can help prevent muscle stiffness, spasms and weakness. Electrostimulation may also be used to stimulate and contract weak facial muscles.

Eye Care: Eye drops, gels and ointments help prevent corneal abrasions and drying when the eyelids are affected. An eye patch may be used to keep the eye closed and moist.

Surgery: For those with severe, chronic facial paralysis not improved by other treatments, surgical options include nerve decompression and facial reanimation procedures.

Alternative Medicine: Acupuncture, chiropractic adjustment and hyperbaric oxygen therapy are sometimes used to aid nerve and muscle recovery.

For most patients, corticosteroids and facial rehabilitation yield good results. But additional strategies should be considered for those with severe or long-term symptoms.

Eye care is crutial

Proper eye care is crucial in cases of Bell's palsy where there is incomplete eyelid closure. Damage to the cornea is a frequent complication when the eyelids are unable to fully close and blink. It is strongly advised to use moisturizing eye drops regularly and tape the affected eyelid closed at night to protect the eye and prevent corneal abrasions or ulcerations. Taking these steps helps prevent vision loss and other problems that can result from insufficient lubrication and protection of the cornea.

The Role of Nutritional Supplements in Bell's Palsy Recovery

Integrative neurology doctors also recommend nutritional supplements that may support facial nerve recovery, reduce inflammation and help regenerate nerve myelin sheaths. Options to discuss with your neurologist include:

Vitamin B12: Critical for nerve function. B12 deficiency is linked to nerve damage. Supplements may help rebuild myelin and nerve fibers. The patients receiving methylcobalamin recovered faster
Niacin (B3): Helps increase blood flow to deliver nutrients to nerve and muscle tissue. Also has anti-inflammatory effects.
Acetyl-L-carnitine: This amino acid helps produce myelin and nerve growth factors. It speeds conduction along damaged nerves. *L-carnitine should not be used in high doses in patients with renal impairment. 

Studies suggest these supplements taken early in treatment may hasten recovery from facial palsy. They are considered safe additions to standard drug and rehab protocols under medical supervision.


Don't Wait to Treat Bell's Palsy

Bell’s palsy can be alarming when half your face suddenly becomes paralyzed. But with proper treatment and patience, most people make a full recovery. See your neurologist right away if you develop sudden facial weakness for an accurate diagnosis and treatment plan. Acting quickly gives you the best chance of reversing your symptoms and avoiding potential complications.

Get physician grade supplements

When considering nutritional supplements for Bell's palsy recovery, it is advised to only use high quality products without unnecessary additives or artificial colors. Opt for supplements from reputable manufacturers that contain the vitamins, minerals, and amino acids in their most bioavailable and purest forms. Stay away from products with many fillers, binders, preservatives, or other potentially harmful ingredients. Choosing supplements wisely will provide the best chance of benefiting from these complementary therapies while avoiding any risks from low quality or impure products. 

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