Bell's Palsy

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Signs and Symptoms

The most common symptoms of Bell's palsy are facial weakness or paralysis, a dry eye or mouth, and problems tasting. The severity of symptoms depends on the extent of facial nerve damage and varies from mild weakness to complete paralysis. Bell's palsy usually affects both the upper and lower parts on one side of the face. Both sides of the face are affected in less than 1% of cases.

Symptoms usually come on suddenly; in about 60% of cases, patients are recovering from a recent upper respiratory infection or other viral infection. Several hours before the onset of facial weakness, many people experience pain behind the ear or in the back of the head. In addition to paralysis of the face, other symptoms include the following:

• Dizziness
• Drooling
• Dry mouth
• Facial twitching
• Hypersensitivity to sound
• Inability to blink or close the eye, tearing, and dry eyes
• Impaired sense of taste
• Impaired speaking

Bell's palsy is self-limiting. Symptoms do not spread beyond the face and do not worsen once they "peak." Between 60% and 80% of patients experience complete recovery within a short time, whether or not they receive treatment. Others are left with varying degrees of facial disfigurement, paralysis, or muscle spasms.

Recovery time varies from a few days to a few months, depending on the amount of damage to the facial nerve. Approximately 7–10% of patients experience a recurrence.

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