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Bell’s Palsy: How Is It Diagnosed and Treated?

Reviewed by Christopher Melinosky, MD on October 16, 2020

There’s no test that can tell you for sure if you have Bell’s palsy. In fact, doctors usually find out through what they call a "diagnosis of exclusion." That means in most cases, they determine you have Bell's palsy only after other conditions have been ruled out.

Your doctor will start by doing a complete and careful physical exam. If they suspect you have Bell’s palsy, they’ll try to close your eyelid on the affected side of your face. If it doesn’t close, it’ll signal that you have what doctors call “the Bell phenomenon.” With this condition, your eye rolls upward and outward when you try to close it.

Your doctor will then try to rule out other conditions. They’ll probably test your hearing and sense of balance. They may also order several tests, such as skull X-rays, a computed tomography (CT) scan, or magnetic resonance imaging (MRI). Electrical testing may help clarify the diagnosis. It may also help them predict how fast and fully you’ll recover.

What Are the Treatments for Bell's Palsy?

There aren’t any that can stop it. If your doctor suggests your symptoms might be triggered by the herpes virus (herpes simplex 1) or by shingles (herpes zoster), they may give you an antiviral medication, like acyclovir. But there’s no research to show these medications work to reduce Bell’s palsy symptoms.

Your doctor may also give you a short course of corticosteroids (like prednisone). The goal is to decrease swelling of your facial nerve. This may shorten the duration of your Bell's palsy symptoms.

In the meantime, your doctor will tell you to take extra care to protect your eye on the affected side. They may suggest you wear an eye patch, since you won’t be able to blink. If your eyes are tearing less than normal, you may have to use eye drops to keep them from drying out.

Finally, your doctor may suggest massage of your facial muscles. In very rare cases -- where symptoms don’t improve after some time -- they may suggest surgery to reduce pressure on your facial nerve.

WebMD Medical Reference

Sources

SOURCES:

NHS Choices: “Bell’s Palsy -- Treatment.”

Annals of Indian Academy of Neurology: “Bell’s Palsy: Treatment Guidelines.”

Mayo Clinic: “Bell’s Palsy Treatments and Drugs.”

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