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Health

How to Spot Bell’s Palsy

Kristie Rivers, MD, FAAP, Board Certified Pediatrician
January 3, 2019 . 2 min read

Any parent would be concerned if their child suddenly developed weakness and drooping on one side of the face. Bell’s palsy is one of the most common reasons for these symptoms to develop. Bell’s palsy is a weakness that affects only one side of the face, often developing over just a couple days. Because the facial nerve is not functioning properly on the affected side, the face appears to droop.

When working properly, the facial nerve carries messages from the brain to the face muscles, telling the eye to blink, the mouth to smile, and the salivary glands to make saliva. When the facial nerve is affected, it becomes inflamed and swollen, causing it not to work correctly. As a result, the face muscles become weak or paralyzed on the affected side. This can cause symptoms such as:

Downward drooping mouth

Difficulty closing the affected eye all the way, causing dryness and irritation

Difficulty making saliva

Difficulty tasting

Headache

Louder than usual sounds in the affected ear

Some children are more affected than others, with some having only mild weakness and others developing full-blown symptoms of facial paralysis.

Bell’s palsy is often due to a viral infection. The most common viruses include the herpes virus (HSV-1) that causes the common cold sore. Other common viruses include the Epstein Barr virus (that causes mononucleosis) and the influenza virus. Often, the viral infection that causes Bell’s palsy is so mild that children do not even have symptoms of an infection and do not feel sick. Other times, the viral symptoms have already passed, and then the child develops the Bell’s palsy. Other more uncommon causes include ear infections, Lyme disease, and head or face trauma.

There is no specific test to diagnose Bell’s palsy. Your child’s doctor will rely on the physical findings to see if they fit the picture of Bell’s palsy. If your child has weakness of other parts of the body as well, having difficulty seeing or swallowing, seek medical attention right away as other more serious problems may be the cause.

There is no specific cure for Bell’s palsy. Some children will be treated with an anti-viral medication, while others may be given a course of oral steroids in an attempt to calm the inflamed nerve. Some children may require an eye patch and lubricating eye drops if the eye is dry from not fully closing. Typically, Bell’s palsy goes away within 1-3 months, although a few people will continue to have some residual weakness.

Sources:

  • Singhi P, Jain V
  • Bell’s palsy in children
  • Semin Pediatr Neurol
  • 2003 Dec;10(4):289-97
  • Review.
    American Family Physician
  • Bell’s Palsy: Diagnosis and Management.
    UpToDate
  • Facial nerve palsy in children.

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