The Most Common Treatments for Bell’s Palsy

September 21, 2023

Most people who have Bell’s palsy will eventually recover, either with or without treatment. However, there is no single procedure that works for everyone with Bell’s palsy. In some cases, a physician will recommend physical therapy or medication to decrease the recovery time. Surgery is also a treatment option but is less common.

Caring for the eye is the most important single treatment. Since the affected side’s eye cannot close, it must be cared for and protected, or else devastating complications can result, such as corneal abrasions, traumatic cataracts, and even blindness in the most severely neglected cases. Lubricating eye drops can be used during the day while an ointment can be used at night to ensure the eye stays moist. Wearing goggles or an eye patch at night and glasses during the day can also prevent the eye from becoming scratched or poked. In serious cases, an eye doctor may be required to monitor the eye.

Medications to Treat Bell’s Palsy

There are two types of medication commonly used to treat Bell’s palsy. The first type is corticosteroids, like prednisone. This is a robust anti-inflammatory medication. If the swelling of the facial nerve is lessened, it feels more comfortable in the bony area around it.

Those who have the best results from corticosteroids are the ones who start treatment immediately after onset, or within a few days of noticing symptoms. Starting steroids early increases the likelihood of full recovery.

Antivirals are another type of medication used for Bell’s palsy. However, there is controversy about whether these medications help. Taking antivirals on their own compared to placebos has shown no benefits. Some people with Bell’s palsy who take steroids and antivirals together may see a benefit but this is not yet proven.

Treatment Through Physical Therapy

When muscles in the human body are paralyzed, this can cause them to shorten and shrink. In some cases, this could be permanent. Physical therapists can teach a patient how to exercise and massage the facial muscles to ensure this doesn’t occur.

Types of Surgery for Bell’s Palsy

In the past, surgical decompression was a common treatment for Bell’s palsy. This surgery is done to relieve pressure on the facial nerve by opening the passage the nerve goes through. Most of the time, this is no longer recommended.

Surgical decompression might be offered if the patient has more than 90% degeneration in electroneuronography testing and no voluntary electromyography motor unit potentials within the first several weeks of the onset of symptoms.

Additional Information About Bell’s Palsy Treatment

One thing to keep in mind is that most people will recover spontaneously even without any treatment. However, approximately 30% will have incomplete or delayed recovery. This is why treatment is often recommended to increase the chances of a full recovery.

If treatment is delayed for Bell’s palsy, some treatment methods may help. For instance, facial retraining, facial reanimation procedures, and surgical or medical treatment for synkinesis are all options.

Facial reanimation helps the face seem more even and can restore facial movement. Examples of this type of surgery include nerve grafts, eyelid lifts, and eyebrow lifts. Sometimes these procedures may need to be repeated after several years.