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.

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:

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:

Poor prognostic factors include:

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.

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.

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:

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.

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4. KIME CE. Bell's palsy: a new syndrome associated with treatment by nicotinic acid; a guide to adequate medical therapy. AMA Arch Otolaryngol. 1958 Jul;68(1):28-32. doi: 10.1001/archotol.1958.00730020032004. PMID: 13544680.

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