How is Bell's palsy managed or treated?

Bell’s palsy improves without treatment. Still, your healthcare provider may recommend one or more of these therapies for symptom relief and a faster recovery:

  • Oral corticosteroids, such as prednisone, decrease nerve swelling and may help you regain facial movement faster. This treatment is most effective when you start it within 48 hours of noticing symptoms.
  • Antiviral medications, such as acyclovir for herpes, may speed recovery, although it is unclear how much benefit they provide. This treatment works best when combined with oral corticosteroids.
  • Eye care is very important. Eyedrops, including artificial tears, soothe dry, irritated eyes. If your eyelid won’t close, you may need to wear an eye patch to protect the eye from irritants and injuries.
  • Decompression surgery eases pressure on the nerve is rarely performedbecause it can cause hearing loss and permanent facial nerve damage.
  • Functional facial plastic surgery procedures are options for indivduals that do not recover to help correct facial asymmetry and assist with eyelid closure.

What are the complications of Bell’s palsy?

Eight out of 10 people with Bell’s palsy recover fully without any lingering problems. Unfortunately, 20% of people have long-term facial paralysis and drooping. While uncommon, Bell’s palsy can come back, usually within two years of the initial diagnosis. A recurrence may affect the same side of the face or the opposite side.

How does Bell’s palsy affect pregnancy?

For unknown reasons, pregnant women are three times more likely to develop Bell’s palsy than women who aren’t expecting. The condition typically occurs during the third trimester. You may be more likely to develop Bell’s palsy while pregnant if you have preeclampsia (high blood pressure) or gestational diabetes.

If your symptoms are severe, your healthcare provider may recommend treatment. Certain treatments, such as oral corticosteroids, may increase your risk of giving birth prematurely before the 37th week of pregnancy. Your healthcare provider can discuss treatment risks and benefits with you.

Last reviewed by a Cleveland Clinic medical professional on 05/29/2020.

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