The Disease Course
In about 80 percent of cases, Bell’s palsy resolves completely within three months. However, 15 percent of patients will experience facial asymmetry, and 5 percent will show persistent neurologic impairment or disfigurement (Brody 1999; Lambert 2004).
Besides antiviral drugs, the standard treatment for Bell’s palsy is corticosteroids (e.g., prednisone). Corticosteroids have been shown to reduce inflammation of the facial nerve, which minimizes compression and damage (Adour 1996), although a few studies have found that steroids are ineffective (Salinas 2004). Some studies have also suggested that antivirals are effective only if prescribed early in the disease process (Lejeune 2002).
In severe cases, surgical treatment might be recommended, although surgery is associated with a high risk of hearing loss, and many clinicians recommend against it. The surgery used to treat Bell’s palsy is known as decompression surgery. It is used to relieve pressure on the affected facial nerve.
A number of alternative or complementary therapies have been studied for Bell’s palsy. Many people believe that facial massage will help relieve the condition, although there is evidence that facial massage will not help (Kasper 2005). Acupuncture combined with exercise therapy has been shown to increase therapeutic effect, with a cure rate of 66.7 percent among people on combined therapy compared with a cure rate of 46.7 percent in the control group (Qu 2005).
Vitamin B12 has also been documented to improve the symptoms of Bell’s palsy. In one study, three groups of patients were tested: one received methylcobalamin (vitamin B12), one received corticosteroids, and the third received methylcobalamin in combination with corticosteroids. At the end of the study, the patients in both methylcobalamin groups showed greater improvement in their symptoms than those in the corticosteroid group (Jalaludin 1995).
Other supplements have attracted attention in Bell’s palsy but have not been subjected to rigorous scientific testing. Some people with Bell’s palsy report symptom relief from omega-3 fish oils, a natural anti-inflammatory that may work by relieving nerve inflammation (Bell’s Palsy Association 2004).