University of Iowa Health Science Relations and
Jay Rubinstein, MD, MS, PhD
Associate Professor of Otolaryngology-Head & Neck Surgery/Biomedical Engineering
First Published: November 2000
Last Revised: March 2004
Peer Review Status: Internally Peer Reviewed

Waking up and smiling each day is something most people take for granted. However, being affected by Bell's palsy robs 400 to 1,200 Iowans each year of the ability to smile.

"Bell's palsy is a sudden facial paralysis," says Dr. Jay Rubinstein, associate professor of otolaryngology and biomedical engineering at the University of Iowa College of Medicine and a staff physician at the UI Hospitals and Clinics. "It is a loss of function or weakness of facial muscles."

Within 24 to 48 hours, the damaged nerve weakening the muscles disables half of a person's face, making it impossible to smile or close the eye on the affected side. Often the eyelid and mouth droop. People with Bell's palsy use eye drops throughout the day and an eye patch at night to keep the eye moist.

Bell's palsy affects 15 to 40 out of every 100,000 people each year, Rubinstein says. It occurs in people of all ages, and is equally common among men and women. This condition, which is more common in pregnant women and people with diabetes, typically does not cause any ear trouble or other nerve damage. A strongly suspected cause of this condition is herpes simplex virus, but a cure and specific cause remain unknown.

Rubinstein suggests consulting an otolaryngologist as soon as Bell's palsy is diagnosed to determine how severely the facial nerve is damaged and to verify no other cause for facial weakness, such as a tumor. If left untreated, recovery may be more difficult.

Your physician may use electrical testing called electroneuronography to record how much the facial nerve has degenerated. For the majority of patients who have partial nerve deterioration, facial movement will spontaneously return within three to six months. Prednisone is commonly prescribed to help decrease swelling of the nerve and prevent further damage.

Half of the patients with complete nerve degeneration also will recover. With prompt surgical intervention, most cases will recover as well. The length and success of recovery depend upon how severely the nerve was damaged.

Although extremely rare, Bell's palsy may recur, Rubinstein says. It strikes as swiftly as the initial episode and may or may not affect the same side of the face.