ZocdocAnswersDoes Bell's palsy have any long term affects?

Question

Does Bell's palsy have any long term affects?

My brother has Bell's palsy, where his facial muscles are sagging. His doctor is giving him medication that's supposed to help it get back to normal. Will this affect him the rest of his life? Can he get it again later? He's really scared!

Answer

Sorry to hear that your brother developed Bell's palsy, and that he is very scared about it. This can be a very anxiety provoking illness as the face is such a big part of how we identify ourselves, and how others perceive us. I am glad that he is seeing a physician. Bell's palsy is a medical term that we use to describe idiopathic (usually unilateral) facial nerve palsy. "idiopathic" just means that we don't know the cause. In fact, strictly speaking if the cause is known, then it isn't really Bell's palsy. The facial nerve provides innervation for the muscles of facial animation on one side of the face, taste to the ipsilateral two thirds of the tongue, and innervation of the stapedial muscle in the ear that helps dampen/protect hearing when there are loud noises. Usually it is the rapid onset (over a day or two) of facial immobility that is first noticed with Bell's. There are many theories about why people get Bell's, and most of them involve the thinking that there is some sort of inflammatory process within the affected nerve (cranial nerve 7 in this case aka "facial nerve"). Some think it is a viral infection that leads to this inflammatory process. Nonetheless the facial nerve travels through the ear in bony canals to make it to the facial muscles, so if it swells, it can compress easily. This is why treatment is usually focused on decreasing inflammation that may be present (with high dose steroids). Many physicians will also add an anti-viral. The majority of cases of Bell's are self limiting, but unfortunately there are patients who never regain function, or only partially regain some function. I would recommend that your brother make an appointment to be seen by an ENT if he hasn't already to be evaluated. I hope that this information is helpful. Best of luck.

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