Bell’s Palsy

Publication Date: November 4, 2013
Last Updated: September 2, 2022


When evaluating a patient with facial paresis/paralysis for Bell’s palsy, the following should be considered:

  • Bell’s palsy is rapid in onset (<72 hours).
  • Bell’s palsy is diagnosed when no other medical etiology is identified as a cause of the facial paresis/paralysis.
  • Bilateral Bell’s palsy is rare.
  • Currently, no cause for Bell’s palsy has been identified.
  • Other conditions may cause facial paresis/paralysis, including stroke, brain tumors, tumors of the parotid gland or infratemporal fossa, cancer involving the facial nerve, and systemic and infectious diseases, including varicella zoster, sarcoidosis, and Lyme disease.
  • Bell’s palsy is typically self-limited. Most patients with Bell’s palsy show some recovery without intervention within 2-3 weeks after onset of symptoms and completely recover within 3-4 months.
  • Bell’s palsy may occur in men, women, and children but is more common in persons 15-45 years old; individuals with diabetes, upper respiratory ailments, or compromised immune systems; and during pregnancy.


Table 4. Summary of Guideline Action Statements
Patient history and physical examination
Clinicians should assess the patient using history and physical examination to exclude identifiable causes of facial paresis/paralysis in patients presenting with acute-onset unilateral facial paresis/paralysis. ( C , S )



Bell’s Palsy

Authoring Organization