Bell’s Palsy Symptoms – A Comprehensive Guide

Bell’s Palsy is the paralysis of the facial muscles caused by damage or constriction of the facial nerve (the 7th Cranial nerve) resulting in facial palsy to one side of the face (in 1% of cases this can occur on both sides of the face: Bilateral Bell’s Palsy).

Here is a comprehensive list of the most common physical Bell’s Palsy symptoms. This is not an exhaustible list and a Bell’s Palsy sufferer may or may not get some or all of them.

Certainly, when under the stress of getting acquainted with having facial paralysis, just knowing that a symptom is “possible”, that it has happened to others and is therefore nothing to worry about, is, in itself, extremely helpful.

It is most definitely useful for the friends and family of the Bell’s Palsy sufferer to be aware of this list, so that they can more immediately understand what the person with Bell’s Palsy is actually going through and can remind them that the latest “panic” is actually on this list and is therefore something that is “normal”.

The real symptoms of Bell’s Palsy – A comprehensive guide

  • Facial muscle paralysis or a weakness of the facial muscles giving an overall lop-sided appearance to facial expression. Bilateral Bell’s Palsy (a rare occurrence in approximately 1% of cases) produces a face with no expression whatsoever.
  • The facial skin loses any wrinkling (it is an ironically pleasing experience as they return)
  • Difficulty closing the eye on the affected side.
  • A extremely dry eye or an excessively watery eye as Bell’s Palsy affects both tear gland and tear duct function.
  • A pronounced “open” eye on the affected side due to the inability of the Orbicularis Oculi muscle (the muscle surrounding the eye socket) to keep the lower eyelid in its normal place. This makes the surface of the eye dangerously exposed to likes of dust and debris and this must be protected against.
  • “Bell’s Phenomenon” is a common Bell’s Palsy symptom. When attempting to close your eyelids the “eyeball” on the affected side will disappear upwards behind the affected eyelid. This is not really noticeable to the owner of the eye, but is very noticeable to a person watching your affected eye. It is not something to be worried about at all. Although there is no medically scientific reason why this should happen, it is an extremely helpful symptom because it helps protect the affected eye whilst your eyelid cannot. This symptom will go along with the others in the course of time.
  • A slight sensitivity to light most probably due to the fact that you cannot close one of your eyes completely.
  • Crocodile tears. Tears that appear when eating or when you are about to eat. These are not usually problematic, just “odd”. They are a sign of recovery, but if a person does not get them, they are still recovering.
  • Painful teeth (unlike toothache more as if the teeth on the affected side of your face have been frozen into one block. This can pass within a few days and again, is odd, rather than actually painful)
  • A runny or blocked nose.
  • A noticeable difference in the way the person with Bell’s Palsy speaks, due to the paralysis of the Orbicularis Oris (the facial muscle that surrounds the mouth) in conjunction with various other facial muscles, that allow us to move our lips.
  • A noticeable difference in the ease with which the person with Bell’s Palsy can eat and drink (they can eat and drink but it is very different and leads to a great deal of embarrassment and is very upsetting, especially at first) Hyperacusis – A pronounced sensitivity to sound in the ear on the affected side.
  • A feeling that the ear on the affected side is intermittently blocked (as if having partial deafness) upon facial movement when facial movement starts to return. Pain around the area of, or in, the ear of the paralysed side of the face.
  • A noticeable difficulty (impossible with bilateral Bell’s Palsy) to close the lips properly.
  • A drooping bottom lip (especially in Bilateral Palsy)
  • A constant thirst or an overactive saliva gland causing dribbling (This is again very embarrassing and can thus affect mood)
  • Whistling is an impossibility without manual manipulation to hold the lips in their proper place.
  • Facial swelling, or at least the feeling that your face, or parts of it, are swollen.
  • The loss of, or reduction in, taste in the anterior (front) 2/3’s of tongue, relating to the perception of saltiness and sweetness.
  • Eyebrows cannot be raised together equally, or individually on the paralysed side of the face.
  • Major distortions of the face when expressions are attempted, when speaking and when eating.
  • Minor (but stressful at the time) feelings of unsteadiness, or hyper- vigilance. These can occur purely due to the stress or fear of this or any scary situation.
  • Chronic tiredness as would be associated with having a virus (this will go incrementally with rest)
  • As recovery begins, a tingle, mild pain or twitch may be noticed in the area where the facial nerve ending has begun to receive a signal. As a warning, these feelings may appear and then disappear which is extremely upsetting (they usually always return, at which point they are nearly always stronger). A fresh “Twitch” is an extremely encouraging and mood enhancing experience to the Bell’s Palsy recoverer.

Recovery from Bell’s Palsy can take up to 3 months in the majority of cases (50-60%) and within 6 months 80% of people have experienced a complete recovery. Sometimes it can take longer, but healing continues long after the 6 months stage and can even be restarted or boosted many years afterwards with the help of facial exercises, facial retraining or electrical stimulation treatment.