Bell's palsy is a sudden weakness or paralysis on one side of the face that makes it hard for a person to move the mouth, nose, or eyelid and can make that side of the face droop or look stiff. It occurs when one of the facial nerves is not functioning properly, often after a virus.
When the facial nerve is working properly, it carries a host of messages from the brain to the face. These messages may tell an eyelid to close, one side of the mouth to smile or frown, or salivary glands to make spit. But if the nerve swells and is compressed, as happens with Bell's palsy, these messages don't get sent correctly. The result is weakness or temporary paralysis of the muscles on one side of the face.
Bell's palsy is most often connected with a viral infection such as HSV-1 (the virus that causes cold sores), Epstein-Barr (the virus that causes mononucleosis), or influenza (the flu). It's also associated with ear infections, bad colds, the infectious agent that causes Lyme disease, and trauma to the head or face.
In a few people, the immune system's response to a viral infection leads to inflammation of the facial nerve. Because it's swollen, the nerve gets compressed as it passes through a small hole at the base of the skull and stops sending the correct messages from the brain to the face — messages that, among other things, tell one eyelid to blink and the front of the tongue to taste things.
Often the virus or infection that causes Bell's palsy is so mild that some kids don't ever feel sick. Usually the virus or infection has passed before the symptoms of Bell's palsy start to appear.
Bell's palsy tends to happen quickly. Some kids may feel pain behind or in front of their ears for a few hours or even days before the facial weakness sets in.
Because Bell's palsy only happens to one facial nerve at a time, it only affects one side of the face. Some kids have only slight weakness; others may not be able to move that side of their face at all. This may make one half of the child's face (especially the mouth) seem to droop or sag.
Other symptoms may include:
Bell's palsy affects only the facial muscles, so if other parts of the body are stiff or paralyzed, talk with your doctor right away, as it may be a sign of a different condition.
There isn't a specific test for Bell's palsy, so to eliminate other possible causes, your doctor will evaluate how long it took for the symptoms to develop and where the weakness or paralysis is.
People who have strokes usually have weakness only in the lower half of their face and may have it in their arms and legs as well. The problems caused by tumors usually take longer to develop (the symptoms start more slowly and get more serious over a longer period of time) than Bell's palsy does.
The doctor will ask about whether your child is experiencing weakness or paralysis in other parts of the body, and if he or she is having other problems, like double vision or trouble swallowing. The doctor will also want to know about any head injuries.
If you live in an area of the country where Lyme disease is common, your doctor will do a blood test to check for that infection.
If the facial paralysis lasts more than a few months, the doctor is likely to recommend further tests — such as X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) — to rule out other problems. The doctor also might recommend that your child have an electromyography (EMG), which tests how well the muscles are responding to the nerves' signals.
Usually, the virus or infection that leads to Bell's palsy has passed, so there's no specific treatment used for the condition. It goes away once the swelling of the nerve goes down and the nerve recovers from any damage it caused. The nerve has to renew itself and that can only happen with time.
In some cases doctors can offer medications to help reduce the swelling or prescribe an eye patch or eye drops if the child's eye is dry.
Most people recover fully within 1 to 3 months, whether or not the condition is treated, although some will have permanent weakness in their face afterward. It is very unusual for anyone to get Bell's palsy twice.
Making sure your child eats well and gets plenty of sleep are important to healing. Activities and sports participation don't have to be limited as long as your child can close the eye (to protect it). If the eye can't be closed, talk with the doctor about using protective glasses or a patch to prevent eye damage.
Bell's palsy can be tough for kids because it affects their appearance so dramatically. Reassure your child that his or her face will soon return to normal.
If your child is being teased, consider talking with teachers, school counselors, and coaches — you might even want to speak to the class, if your child is comfortable with that. You also can practice responses with your child in case people ask what's wrong, stare, or say unkind things — explaining that it's a temporary medical problem that isn't contagious will probably satisfy most questioners.
With a little patience, and some extra doses of love and support from you, your child will be feeling better very soon.
Reviewed by: Mena T. Scavina, MD
Date reviewed: June 2012
|National Institute of Neurological Disorders and Stroke (NINDS) NINDS offers research information related to neurological disorders.|
|American Academy of Pediatrics (AAP) The AAP is committed to the health and well-being of infants, adolescents, and young adults. The website offers news articles and tips on health for families.|
|Neuroscience for Kids This University of Washington site offers kids a wide range of information about the brain and nervous system. Kids will find experiments and kid-friendly explanations of this complex subject.|
|American Academy of Family Physicians This site, operated by the American Academy of Family Physicians (AAFP), provides information on family physicians and health care, a directory of family physicians, and resources on health conditions.|
|Lyme Disease Lyme disease can affect the skin, joints, nervous system, and other organ systems. If diagnosed quickly and treated with antibiotics, Lyme disease in kids is almost always treatable.|
|Immune System The immune system, composed of special cells, proteins, tissues, and organs that protect against germs and microorganisms, is the body's defense against disease.|
|Stroke A stroke means that something has stopped the normal blood flow to the brain. Find out more in this article for kids.|
|Mononucleosis Mononucleosis - or "mono" - is an infection that produces flu-like symptoms, and usually goes away on its own in a few weeks with the help of plenty of fluids and rest.|
|Brain and Nervous System The brain controls everything we do, and is often likened to the central computer within a vast, complicated communication network, working at lightning speed.|
|Strokes This "brain attack" happens when blood flow to the brain stops, even for a brief second. Signs and symptoms of strokes in kids are similar to those in adults.|
|Cold Sores Cold sores are small and painful blisters that appear around the mouth, face, or nose. They're very common and, while uncomfortable, usually go away on their own.|
|Influenza (Flu) Flu symptoms tend to develop quickly and are usually more severe than the typical sneezing and stuffiness of a cold. Yearly vaccination is the best protection against the flu.|
|Bell's Palsy Bell's palsy is a temporary weakness or paralysis of the muscles on one side of the face. Although it doesn't happen to many people, it can be scary. This article for teens covers the facts.|
|Bell's Palsy Bell's palsy weakens or paralyzes one side of a person's face, but it usually goes away. Find out more in this article for kids.|
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