UMEM Educational Pearls

Title: Bell Palsy - Recognizing Sequelae

Category: Neurology

Keywords: bell palsy (PubMed Search)

Posted: 5/27/2009 by Aisha Liferidge, MD (Updated: 11/23/2024)
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  • The majority of those afflicted with bell palsy experience neurapraxia or a local nerve conduction block, which usually predicts a prompt and full recovery.  80% to 90% of Bell Palsy patients experience recovery without any noticeable disfigurement within 6 weeks to 3 months.
  • Some Bell Palsy patients experience axonotmesis, disruption of the axons, which increases their risk of an incomplete recovery.
  • One is at higher risk of developing sequelae in the following scenarios: 

          --  Age greater than 60 years

          --  Diabetes

          --  Decreased taste or salivary flow on the affected side

          --  Complete paralysis

  • Common post-Bell Palsy sequelae that you may see clinically include:

          --  Synkinesis - abnormal contracture of facial muscles with smiling or

               closing eyes; may cause slight chin movement with blinking, eye closure

               with smiling, contracture around mouth with blinking.

          --  Crocodile tears - lacrimation while eating.

          --  Hemifacial muscle spasms - tonic contractures of affected side of face, 

               rare, often seen during times of fatigue, stress, or while sleeping.