Facial Nerve Problems and Bell's Palsy (Bell Palsy)

  • Medical Author:
    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.

  • Medical Editor: Melissa Conrad Stöppler, MD
    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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What are treatment options of facial nerve paralysis?

There are no medications specifically approved to treat Bell's palsy. Underlying medical conditions that lead to facial nerve disorder are treated specifically according to the specific condition that is responsible for the damage to the nerve. Steroid medications (corticosteroids) are the best treatment for Bell's palsy, and it is recommended that all patients be treated. The usual amount is one milligram per kilogram body weight of prednisone (or steroid alternative) per day for 7 to 14 days. Recently, antiviral medications like acyclovir (Zovirax) given in conjunction with steroids have been demonstrated to increase recovery. Doses of the antiviral agent will vary with the drug chosen.

Although physical therapy and electrotherapy probably have no significant benefit, facial exercises can help prevent contractures of affected muscles. Surgical facial nerve decompression is controversial in Bell's palsy. Some physicians recommend surgical decompression during the first two weeks in patients showing the most severe nerve degeneration; however, there can be a substantial risk of hearing loss with this surgery.

What is the treatment for eye problems from facial nerve disorder?

Patients with facial nerve paralysis have difficulty keeping their eye closed because the muscles which close the eye cannot work. Serious complications can occur if the cornea of the eye becomes too dry. Treatment consists of:

  • protective glasses which can prevent dust from entering the eye;
  • manual closure of the eye with a finger to keep it moist -- patients should use the back of their finger rather than the tip to insure that the eye is not injured;
  • artificial tears or ointments to help keep the eye lubricated;
  • taping or patching the eye closed with paper tape while asleep; and
  • in cases in which recovery is incomplete, a temporary or permanent narrowing of the eye opening (tarsorrhaphy) may be necessary.
Medically Reviewed by a Doctor on 11/6/2015

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