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Symptoms of Bell’s palsy

It is not uncommon for people to wake up and discover the ability to smile, blink, or perform other facial movements is compromised. This facial weakness affects the forehead, eye, cheek, and lip muscles. In addition to muscle weakness, individuals with Bell’s palsy may experience changes in taste, heightened sensitivity to loud noises, and dull pain around or behind the ear.

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What causes Bell’s palsy?

While its precise cause remains unproven, most evidence points to the reactivation of the Herpes Simplex virus, which typically lies dormant within cranial nerves and becomes activated by triggers like stress, fatigue, immunosuppression, or illnesses such as shingles.

How is Bell’s palsy treated?

Approximately 70% of individuals with Bell’s Palsy make a complete recovery. Most medical experts agree that steroids can expedite recovery and enhance overall outcomes. The efficacy of antiviral medications remains somewhat controversial, though valacyclovir appears to offer modest benefits for recovery. Surgical interventions, such as facial nerve decompression, may be appropriate for some patients.

In the early stages of Bell’s Palsy, safeguarding the eye is paramount as patients struggle to blink effectively. Daytime eye drops and nighttime ointments or gels are commonly prescribed, along with taping the eye shut during sleep.

Recovery after Bell’s palsy

Patients who achieve complete recovery do not require physical therapy or additional interventions. However, Bell’s palsy can present challenges for some patients, as approximately 30% experience some ongoing facial dysfunction. Changes in facial function can range from mild to severe, involving tightness on the affected side or involuntary movements when attempting intentional facial expressions. This condition, known as synkinesis, is managed through facial nerve physical therapy, BOTOX injections, and, in some cases, surgical interventions.

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Diagnosing Bell’s palsy

When diagnosing Bell’s Palsy, it’s essential to rule out other potential conditions. If the weakness stabilizes within 72 hours of onset and shows slight signs of improvement within four months, it is most likely Bell’s Palsy.

However, when the condition progresses slowly over weeks to months with no resolution within the initial four months, thorough diagnostic testing is crucial to ensure other underlying pathologies are not overlooked.

How is Bell’s Palsy Treated?

When under the care of our Bell's Palsy Specialist in Boston, Dr. Tessa Hadcock, you will be treated by a worldwide leader in treating facial paralysis. The treatment may include one or more of the following:


Most clinicians agree that steroids can significantly improve the outcome for individuals with Bell’s Palsy. Steroids help speed up the recovery process and improve overall facial muscle function.

Antiviral medications

While there is some debate about their effectiveness, antiviral medications such as valacyclovir may be prescribed alongside steroids. These medications may provide a modest benefit to the recovery process.

Facial nerve decompression surgery

Facial nerve decompression surgery is a subject of ongoing research and discussion in treating Bell’s Palsy. Some surgeons believe relieving external pressure on the facial nerve by drilling the surrounding bone may aid healing. However, the effectiveness of this surgery remains a topic of debate, with varying results in different studies.

Eye protection

In the early stages of Bell’s Palsy, protecting the eye is paramount due to difficulty blinking. Eye drops during the day and thicker ointments and gels at night help keep the eye moist. Taping the eye shut during sleep is a common practice to prevent corneal damage.

Long-term management

Approximately 70% of individuals with Bell’s Palsy recover completely, but for the remaining 30%, some long-term facial dysfunction may persist. The long-term effects could range from mild to more noticeable tightness and involuntary movements of the face. These issues can be managed through facial nerve physical therapy, BOTOX injections, and occasionally surgical interventions.

Dr. Hadlock's Insights on Treating Acute Bell's Palsy!

Why choose us for Bell’s Palsy care?

At the Hadlock Center for Facial Plastic Surgery, we offer a comprehensive and personalized approach to Bell’s Palsy treatment in Boston. Dr. Tessa Hadlock, our founder, is a Bell's Palsy specialist and a renowned clinician-scientist with extensive experience in facial plastic and reconstructive surgery.

Her groundbreaking research and innovative techniques have transformed the field. Dr. Hadlock’s dedication to advancing the field means you benefit from the latest advancements in facial plastic and reconstructive surgery. Her research has been instrumental in improving the lives of patients with facial paralysis.

Bell’s palsy can be a challenging condition, but with the right care and treatment, individuals can regain control over their facial expressions and improve their quality of life. Choose the Hadlock Center for Facial Plastic Surgery for compassionate and effective Bell’s Palsy care.

When to seek help

If you or someone you know is experiencing facial weakness or paralysis, especially if it develops suddenly, it’s essential to seek medical attention without delay. Bell’s palsy can often be diagnosed and treated effectively, but other conditions with similar symptoms need to be ruled out if the condition does not resolve within the usual timeframe. Early intervention and treatment can lead to better outcomes and improved quality of life.

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