FREQUENTLY ASKED QUESTIONS

WHAT IS BELL'S PALSY?
Bells palsy is a condition that causes the facial muscles to weaken or become paralyzed. It's caused by trauma to the 7th cranial nerve, and is not permanent.

WHY IS IT CALLED BELL'S PALSY?
The condition is named for Sir Charles Bell, a Scottish surgeon who studied the nerve and its innervation of the facial muscles 200 years ago.

HOW COMMON IS BELL'S PALSY?
Bells palsy is not as uncommon as is generally believed. Worldwide statistics set the frequency at just over .02% of the population (with geographical variations). In human terms this is 1 of every 5000 people and 40,000 Americans every year.

IS BELL'S PALSY ALWAYS ON THE SAME SIDE?
The percentage of left or right side cases is approximately equal, and remains equal for recurrences.

IS THERE ANY DIFFERENCE BECAUSE OF GENDER OR RACE?
The incidence of Bells palsy in males and females, as well as in the various races is also approximately equal. The chances of the condition being mild or severe, and the rate of recovery is also equal.

WHAT CONDITIONS CAN INCREASE THE CHANCE OF HAVING BELL'S PALSY?
Older people are more likely to be afflicted, but children are not immune to it. Children tend to recover well.

Diabetics are more than 4 times more likely to develop Bells Palsy than the general population.

Conditions that compromise the immune system such as HIV or sarcoidosis increase the odds of facial paralysis occurring and recurring.

CAN BELL'S PALSY EFFECT BOTH SIDES OF THE FACE OR CAUSE WEAKNESS ANYWHERE ELSE?
It is possible to have bilateral Bells palsy, but is rare, accounting for less than 1% of cases. With bilateral facial palsy, it's important to rule out all other possible diagnoses.

Bells palsy should not effect any other part of the body. If any other areas become weak or numb, further testing should be done.

HOW DO THE SYMPTOMS OF BELL'S PALSY PROGRESS?
Very quickly. Most people either wake up to find they have Bells palsy, or have symptoms such as a dry eye or tingling around their lips that progress to classic Bell's palsy during that same day. Occasionally symptoms may take a few days to be recognizable as Bells palsy. The degree of paralysis should peak within several days of onset - never in longer than 2 weeks (3 weeks maximum for Ramsey Hunt syndrome).

A warning sign may be neck pain, or pain in or behind the ear prior to palsy, but it is not usually recognized in first-time cases.

WHAT ABOUT RECOVERY FROM BELL'S PALSY?
Approximately 50% of Bells palsy patients will have essentially complete recoveries in a short time. Another 35% will have good recoveries in less than a year.

Regardless of the trigger, Bell's palsy is best described as an event - trauma to the nerve. As with any other injury, healing follows. The quality and duration of recovery is dependent on the severity of the initial injury.

If the nerve has suffered nothing more than a mild trauma, recovery can be very fast, taking several days to several weeks. An "average" recovery is likely to take between a few weeks and a few months.

The nerve regenerates at a rate of approximately 1-2 millimeters per day, and can continue to regenerate for 18 months, probably even longer. Improvement of appearance can continue beyond that time frame.

IS MUSCLE ATROPHY A CONCERN?
Not as a rule. It takes longer for the muscles to start to atrophy than it takes for most people to fully recover.

IS BELL'S PALSY LIKELY TO HAPPEN AGAIN?
The possibility of recurrence had been thought to be as high as 10 - 20%. These figures have been lowered as more has been learned about conditions that are now diagnosed as other types of facial palsies. Estimates of the rate of recurrence still vary widely, from around 4 - 14%. Most recent reports hover at 5 - 9%.

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2/22/06