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Treatments and drugs
By Mayo Clinic staffMost 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.
Medications
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, such as acyclovir (Zovirax) or valacyclovir (Valtrex), may stop the progression of the infection if a virus is known to have caused it. This treatment may be offered only if your facial paralysis is severe.
Physical therapy
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.
Surgery
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.
- Ronthal M. Bell's palsy: Pathogenesis, clinical features, and diagnosis in adults. http://www.uptodate.com/home/index.html. Accessed Jan. 10, 2012.
- Bell's palsy fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/bells/detail_bells.htm. Accessed Jan. 10, 2012.
- Ronthal M. Bell's palsy: Prognosis and treatment in adults. http://www.uptodate.com/home/index.html. Accessed Jan. 10, 2012.
- Bell's palsy. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/neurologic_disorders/neuro-ophthalmologic_and_cranial_nerve_disorders/bells_palsy.html?qt=&sc=&alt= . Accessed Jan. 10, 2012.
- Numthavaj P, et al. Corticosteroid and antiviral therapy for Bell's palsy: A network meta-analysis. BMC Neurology. 2011;11:1
- Van der Veen EL, et al. A small effect of adding antiviral agents in treating patients with severe bell palsy. Otolaryngology — Head and Neck Surgery. In press. Accessed Jan. 10, 2012.
- McAllister K, et al. Surgical interventions for the early management of Bell's palsy. Cochrane Database of Systematic Reviews. 2011;(2):CD007468. http://www2.cochrane.org/reviews. Accessed Jan. 10, 2012.
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