Treatment of Bell’s Palsy
The treatment of Bell’s palsy for Bell’s palsy focuses on reducing inflammation, supporting nerve healing, and protecting the eye on the affected side. Most patients recover fully within a few weeks to months, especially if treatment begins early.
Key treatments include:
- Corticosteroids
- Prednisone is the most commonly prescribed steroid.
- Best started within 72 hours of symptom onset.
- Reduces nerve inflammation and improves chances of full recovery.
- Antiviral medications
- May be added if a viral cause (especially herpes simplex) is suspected.
- Common antivirals include acyclovir or valacyclovir, although evidence of benefit is mixed.
- Eye care
- The affected eye may not blink or close properly, increasing the risk of dryness and corneal damage.
- Important steps include:
- Artificial tears during the day
- Eye ointment at night
- Wearing an eye patch or taping the eye closed while sleeping
- Pain relief
- Over-the-counter painkillers like paracetamol or ibuprofen may ease ear or facial pain.
- Over-the-counter painkillers like paracetamol or ibuprofen may ease ear or facial pain.
- Physiotherapy and facial exercises
- Facial massages, stimulation, and guided exercises can help prevent muscle stiffness and aid nerve recovery.
- Facial massages, stimulation, and guided exercises can help prevent muscle stiffness and aid nerve recovery.
- Speech or occupational therapy
- In severe or prolonged cases, therapists assist with speech, eating, and facial movement retraining.
In South Africa, public hospitals typically provide prednisone and eye care essentials. Referral to a physiotherapist or neurologist may be available through tertiary centres. In private practice, earlier access to MRI and EMG may guide advanced treatment planning.
Treatment of Bell’s Palsy
Most patients improve within 2–3 weeks, with full recovery in 70–85% of cases. Those with incomplete recovery may experience mild muscle weakness, facial tightness, or residual asymmetry.
Early intervention is crucial. Even in remote or rural settings, starting steroids and protecting the eye can make a significant difference.
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