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Medical Author:

Danette C. Taylor, DO, MS, FACN

Danette C. Taylor, DO, MS, FACN

Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Facial nerve problems and Bell's palsy facts
• What is the facial nerve?
• What are symptoms of a facial nerve problem?
• What conditions affect the facial nerve?
• How are the causes of facial nerve dysfunction diagnosed?
• What is and what causes Bell's palsy?
• What are the symptoms of Bell's palsy?
• What is the mechanism of injury in Bell's palsy?
• What are treatment options of facial nerve paralysis?
• What is the treatment for eye problems from facial nerve disorder?
• What surgical reconstruction options are available?
• What is the prognosis for facial nerve problems?
• Can facial nerve problems be prevented?
• Find a local Neurologist in your town
• Facial Nerve Problems Index

Bell's palsy (Bell palsy) is paralysis of the facial nerve of unknown cause. The diagnosis is made when no other cause can be identified. Although Bell's palsy is thought to be caused by a viral infection of the facial nerve, this hasn't been proven. Other names for this condition are "idiopathic facial palsy" or Antoni's palsy.

Bell's palsy is usually a self-limiting, non-life-threatening condition that resolves spontaneously, usually within six weeks. The incidence is 15 to 30 new cases per 100,000 people per year. There is no predominant age or racial predilection; however, it is 3.3 times more common during pregnancy and slightly more common in menstruating females. In general, the incidence increases with advancing age. Children under the age of 13 seem less at risk of developing Bell's palsy than older individuals.

The typical symptoms of Bell's palsy include:

• Acute unilateral paralysis of facial muscles is present; the paralysis involves all muscles, including the forehead.
• About half the time, there is numbness or pain in the ear, face, neck or tongue.
• There is a preceding viral illness in 60% of patients.
• There is a family history of Bell's palsy in 4% to 10% of patients.
• Less than 1% of patients have bilateral problems.
• There may be a change in hearing sensitivity (often increased sensitivity).

While the actual mechanism of injury of the facial nerve in Bell's palsy is unknown, one proposed mechanism of injury includes:

• Primary viral infection (herpes) sometime in the past.
• The virus lives in the nerve (geniculate ganglion) from months to years.
• The virus becomes reactivated at a later date.
• The virus reproduces and travels along the nerve.
• The virus infects the cells surrounding the nerve (Schwann cells) resulting in inflammation.
• The immune system responds to the damaged Schwann cells, which causes inflammation of the nerve and subsequent weakness or paralysis of the face.
• The course of the paralysis and the recovery will depend upon the degree and amount of damage to the nerve.