These signs can look like stroke symptoms. But sudden paralysis can happen with Bell’s palsy. Viruses or inflammation can trigger this usually temporary condition, causing your face to look lopsided. And make you wonder if you’ve had a stroke. That’s why it’s important to get care from experts who can quickly tell the difference between a stroke and Bell’s palsy.
Our neurologists understand it can be unnerving to discover your face is partly paralyzed. After all, facial movement and expression show everyone who you are. The good news? Bell’s palsy usually goes away without treatment. But we’re here to listen, answer questions and help you understand what to expect next.
Why Choose Cleveland Clinic for Bell’s Palsy Care?
Caring approach:
The expressions on your face show who you are to the world. But when you can’t move parts of your face, it may feel like your world has turned upside down. Our team is here to help make it feel right again — with a listening ear, a shoulder to lean on and expert guidance throughout this journey.
Skilled collaborative providers:
Your face does so many different things. It smiles, eats and sees. That’s why you’ll have a team of providers from different specialties working together to plan your care. You may see providers from neurology, ophthalmology, otolaryngology and plastic surgery during your treatment. Meet our team.
Innovation and research:
Our team always looks for new ways to treat conditions like Bell’s palsy through facial reconstruction and reanimation treatments. We’re now doing a procedure known as free tissue transfer surgery for Bell’s palsy and other facial paralysis. We use a portion of leg muscle and nerves in your face to help correct paralysis.
Virtual visits:
During recovery, you may not feel like leaving the house. That’s ok. When you need a quick check-in with your providers, try a virtual visit. You can still see your care team one-on-one online using an internet connection and your smartphone, tablet or computer — all from the comfort of home.
National recognition:
Cleveland Clinic is a trusted healthcare leader. We're recognized in the U.S. and throughout the world for our expertise and care.
Diagnosing Bell’s Palsy at Cleveland Clinic
Paralysis from Bell’s palsy usually affects only one side of your face. It starts when an infection causes swelling around the nerve that controls how your face moves. This pressure on the seventh cranial nerve can mess up signals to your facial muscles and cause facial paralysis.
Symptoms you might experience with Bell’s palsy
Bell’s palsy symptoms come on suddenly and peak within two or three days. You might only have slight drooping. Or you may have total paralysis on the affected side. You may also have problems eating, drinking and talking. And it’s not unusual to have a headache, facial or ear pain, as well as changes in hearing and taste.
As the swelling and inflammation go down, the nerve signals will start to flow again, and symptoms will subside. But it can take a few weeks or months. It all depends on how severe the nerve injury is. Chances are good that you’ll fully recover from Bell’s palsy. And it usually doesn’t come back (recur).
Any facial paralysis needs attention as it can also be a sign of other conditions, like stroke, Lyme disease, sarcoidosis and diabetes. So, it’s important to see experienced healthcare providers who can rule out these conditions.
What to expect at your first appointment
When you first meet with your provider, you’ll want to be prepared to answer a lot of questions. Understanding what’s going on from your perspective helps our team diagnosis and plan your care.
Your provider will want to know:
- What symptoms do you have?
- How long have you had these symptoms?
- How are these symptoms affecting your life?
- Have you had any recent illnesses or infections?
- Have you been diagnosed with any other health conditions?
After taking a complete medical history, your provider will also do a physical exam to check out your overall health. Based on your history and their examination, your provider will order tests to see if you have Bell’s palsy or another condition.
Testing for Bell’s palsy
There are different tests we can do to confirm a diagnosis. We may do imaging tests like an MRI (magnetic resonance imaging) or CT scan (computed tomography scan) of your brain see if you’ve had a stroke or something else that’s caused nerve damage. And you may have blood tests to look for conditions that can cause facial paralysis like Lyme disease or sarcoidosis.
Your provider may also have you get electromyography (EMG). This test measures your nerve activity to help your provider to see how extensive the nerve damage may be and help our team predict how long your recovery could be.
Meet Our Bell’s Palsy Team
Your Bell’s palsy care team will include providers from many different specialties. These experts work closely together to give you the most comprehensive and compassionate care. Your team may include:
- Neurologists.
- Ophthalmologists (eye specialists).
- Otolaryngologists (ear, nose and throat specialists).
- Plastic surgeons.
Providers Who Treat Bell's Palsy
Locations
Our healthcare providers see patients at convenient locations in Ohio, Florida and London.Treating Bell’s Palsy at Cleveland Clinic
Usually, recovering from Bell’s palsy simply takes time. But it’s important to remember that no one experiences Bell’s palsy in the same way. For most people, Bell’s palsy often improves without treatment. But there are ways to ease your symptoms. And maybe even speed recovery. Your care team will go over what they think will work best for you.
Medications
You may take medications like:
- Corticosteroids to reduce swelling around the nerve within the first 48 hours (about two days) after noticing symptoms.
- Antivirals to try to speed recovery. These work best when combined with corticosteroids.
- Eye drops to help dry, irritated eyes. This may include artificial tears. We may have you wear a protective eye patch if your eyelid stays open. Doing this protects your eye from drying which can damage the cornea or lead to possible infection that could damage your eyesight.
Surgery
If there’s no recovery with Bell’s palsy, our team will consider using surgery to treat it. They may recommend decompression surgery to reduce pressure on your cranial nerve. This can help prevent hearing loss or permanent facial nerve damage.
And if your Bell’s palsy doesn’t go away on its own, we can do facial plastic surgery. This can fix uneven features or eyelids that don’t close on their own. We’ve also started using a new treatment called free tissue transfer to help permanent paralysis. We take part of your leg muscle (gracilis muscle) and reverse facial paralysis. We do this by connecting your leg muscle’s nerves and blood vessels in the area of your face that’s paralyzed. This is called facial reanimation.
Taking the Next Step
If your face has suddenly become paralyzed on one side, a million things are probably running through your head. And you may start worrying if you’ve had a stroke. We’re here to assure you that’s not always the case and help figure out if it could be Bell’s palsy. And if you do have this condition, you have a great chance of fully recovering with little to no treatment. Our expert team is ready to help you feel and look like yourself again.
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