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Treatments and drugs
By Mayo Clinic staffMost people with Bell's palsy recover fully — with or without treatment. But your doctor may suggest medications or physical therapy to help speed your recovery. Surgery is rarely an option for Bell's palsy.
Medications
Study results have been mixed regarding the effectiveness of two types of drugs commonly used to treat Bell's palsy: corticosteroids and antiviral drugs.
- 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.
- Antiviral drugs, such as acyclovir or valacyclovir, may stop the progression of the infection if a virus is known to have caused it.
Some clinical studies show benefit from early treatment with corticosteroids, antivirals or a combination of both types of drugs. Other studies don't. Evidence of the effectiveness of corticosteroids appears to be stronger than that for antiviral drugs, and they tend to be most effective when given within three days of the appearance of symptoms.
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
One way to relieve the pressure on the facial nerve is to surgically open the bony passage through which it passes. This decompression surgery is controversial and rarely recommended. In some cases, however, plastic surgery may be needed to make your face look and work better.
- Bell's palsy fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/bells/detail_bells.htm. Accessed Nov. 10, 2009.
- Ronthal M. Bell's palsy. http://www.uptodate.com/home/index.html. Accessed Nov. 11, 2009.
- Bell's palsy. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/HealthInformation/bellsPalsy.cfm. Accessed Nov. 10, 2009.
- Bell's palsy. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec16/ch219/ch219i.html. Accessed Nov. 11, 2009.
- Cardoso JR, et al. Effects of exercises on Bell's palsy: Systematic review of randomized controlled trials. Ontology & Neurotology. 2008;29:557.
- De Almeida JR, et al. Combined corticosteroid and antiviral treatment for Bell palsy: A systematic review and meta-analysis. Journal of the American Medical Association. 2009;302:985.
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