Bell's palsy

What is Bell's palsy?

Bell's palsy is sudden loss of feeling and muscle control on one side of the face. While this condition is more common in adults, children and adolescents can have Bell's palsy. Usually, Bell's palsy goes away by itself within a few weeks or months. Bell's palsy can be mistaken for a stroke.

Signs and symptoms of Bell's palsy

The signs and symptoms of Bell's palsy come on unexpectedly over 1-2 days. The most obvious sign of Bell's palsy is facial weakness on one side of the face. In rare cases, both sides of the face are affected. Other signs and symptoms may include:

• difficulty smiling or closing the eye on the affected side
• drooping of the face on the affected side
• pain around the jaw
• drooping of the eyebrow on the affected side
• reduced eye tearing on the affected side
• pain near the ear on the affected side
• difficulty tasting food on the front of the tongue

Causes

Bell's palsy occurs when the nerve controlling facial muscles becomes inflamed or swollen. The inflamed nerve cannot do its job of sending messages to your child's facial muscles. Nerves that control tears and taste are also affected.

The definition of Bell’s palsy is that it is unexplained. While the cause of Bell’s palsy is unknown, it is thought to be a reaction to viral infections. Facial weakness can be caused by conditions other than Bell’s palsy. Testing in children with new facial weakness is focused on identifying and treating other causes.

While in adults, the herpes simplex virus is associated with facial nerve weakness, Lyme disease is considered a more common cause in children. Other causes of facial weakness in children include complications of otitis media (ear infection) and mastoiditis.

Treatment

Children with Bell’s palsy are often treated with corticosteroids to reduce the swelling of the facial nerve. If your child cannot close their eye on the affected side, your child’s health-care provider may prescribe an eye patch, eye drops or eye ointment to prevent drying and irritation of the cornea.

Surgery is rarely used to treat this condition.

Children who are diagnosed with facial weakness from other causes, such as Lyme disease, otitis media or mastoiditis, are treated with antibiotics.

What you can do to help your child

Tell your child that the condition will not last, and they will likely recover fully. You may need to help protect the eye that cannot close using lubricating eye drops several times a day. Glasses, eye patches or sunglasses can protect the eye.

Outcomes

Most children (over 90%) with Bell’s palsy recover, but it may take weeks or months.

When to seek medical assistance

If your child is showing some of the signs or symptoms of Bell's palsy, see your child's health-care provider.