Bell's Palsy (Acute Idiopathic Facial Paralysis)

Bell’s Palsy is thought to be due to viral inflammation around the facial nerve as it travels within the base of the skull. It is the most common cause of facial paralysis. Note that Bell’s Palsy is a diagnosis that is made after the exclusion of other possible diagnoses.

The diagnosis of Bell’s Palsy is usually a clinical diagnosis.  This means a physician will make the diagnosis after a history and physical exam are performed in order to exclude other possible causes of facial paralysis, such as stroke or trauma.  Blood tests or imaging (such as an MRI) may be required in certain cases in order to exclude other potential causes of acute facial paralysis.

Treatment of Bell’s Palsy involves taking a brief course of oral steroids and may include an oral antiviral medication as well. Typically, patients who are promptly treated for Bell’s palsy recover facial movement, but the pace of recovery can vary widely between patients.  For example, some patients may recover in just a few weeks while others will show signs of recovery over months. 

If you have a sudden change in facial movement, it is important that you go to your local urgent care, emergency department, or primary care provider immediately to receive prompt medical treatment.  Our surgical specialty clinic can help if some of your symptoms do not improve with time, but we do not provide first-line treatment for Bell’s Palsy. 

After recovery from Bell’s Palsy, some patients may notice unwanted facial movement or muscle spasms, or facial discomfort.  These may be signs of synkinesis and can be improved through treatment at the Stanford Facial Nerve Center.