Most people with Bell's palsy recover fully — with or without treatment. There's no one-size-fits-all treatment for Bell's palsy, but your doctor may suggest medications or physical therapy to help speed your recovery. Surgery is rarely an option for Bell's palsy.
Commonly used medications to treat Bell's palsy include:
- Corticosteroids, such as prednisone, are powerful anti-inflammatory agents. If they can reduce the swelling of the facial nerve, it will fit more comfortably within the bony corridor that surrounds it. Corticosteroids may work best if they're started within several days of when your symptoms started.
Antiviral drugs. The role of antivirals remains unsettled. Antivirals alone have shown no benefit compared with placebo. Antivirals added to steroids are also unlikely to be beneficial.
However, despite this, valacyclovir (Valtrex) is sometimes given in combination with prednisone in people with severe facial palsy.
Paralyzed muscles can shrink and shorten, causing permanent contractures. A physical therapist can teach you how to massage and exercise your facial muscles to help prevent this from occurring.
In the past, decompression surgery was used to relieve the pressure on the facial nerve by opening the bony passage that the nerve passes through. Today, decompression surgery isn't recommended. Facial nerve injury and permanent hearing loss are possible risks associated with this surgery.
In rare cases, plastic surgery may be needed to correct lasting facial nerve problems.
Dec. 16, 2014
- Bope ET, et al. Conn's Current Therapy. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed Nov. 14, 2014.
- Glass GE, et al. Bell's palsy: A summary of current evidence and referral algorithm. Family Practice. In press. Accessed Nov. 14, 2014.
- Ferri FF. Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed Nov. 14, 2014.
- Bell's palsy fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/bells/detail_bells.htm. Accessed Nov. 14, 2014.
- Ronthal M. Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults. http://www.uptodate.com/home. Accessed Nov. 15, 2014.
- Ronthal M. Bell's palsy: Prognosis and treatment in adults. http://www.uptodate.com/home. Accessed Nov. 15, 2014.
- Facial nerve palsy. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/neurologic_disorders/neuro-ophthalmologic_and_cranial_nerve_disorders/facial_nerve_palsy.html?qt=&sc=&alt=. Accessed Nov.16, 2014.
- AskMayoExpert. What is the initial therapy recommended for patients with Bell palsy? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
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