Bell's palsy is considered a "diagnosis of exclusion," meaning that other diseases producing similar symptoms should be considered first. For example, especially in childhood, Lyme disease—a bacterial infection transmitted by tick bite anywhere on body—can produce a very similar picture, and needs to be treated with an antibiotic drug.

In adulthood a different kind of infection, Ramsay Hunt syndrome, needs to be considered, because it should be treated with an antiviral drug. Like Bell's palsy, Ramsay Hunt syndrome damages a facial nerve, but involves varicella zoster virus, same virus that produces chicken pox and shingles. Apart from causing facial weakness, this virus typically produces blisters within ear—or sometimes in mouth or throat—that are not seen in cases of Bell's palsy.

Strokes can also produce weakness on one side of face, but almost always produce weakness in other parts of body as well. Another point of distinction is that strokes seldom interfere significantly with ability to blink or raise an eyebrow.

Fortunately, even without treatment most cases of Bell's palsy do well. About 50% obtain a full recovery within first six months, with first hint of improvement occurring after 10 days to two months. Another 35% obtain good, though sometimes incomplete, recovery within first year.

How about treatment? Prescription drugs often receive most attention because they seem more important or definitive than measures that don't require a doctor's prescription. The two most prescribed medications are anti-inflammatory steroids, like prednisone, and anti-viral drugs, like acyclovir. Based on what is known or suspected about Bell's palsy, their use makes sense. But what seems logical is not always true. Thus far, randomized, controlled trials—the gold standard for judging effectiveness of treatments—have shown minimal if any effect of these drugs on course of symptoms.

A little-heralded treatment is probably most important. And that is to protect eye. With loss of blinking, eye needs to be moistened and cleaned in order to prevent irritation and worst complication—secondary infection of eyeball's surface.

During waking hours this can be accomplished with liberal use of unmedicated eye-drops. At bedtime, a soothing, unmedicated ointment—like Lacrilube—can be squeezed from its tube into lower eyelid sac. Then patient can pad and tape upper and lower eyelids into a shut position overnight. Upon awakening next morning, he or she can uncover eye and resume eye-drop treatments. Any loss of vision should be reported promptly to a physician.

Can Bell's palsy recur? It does in about 5-9% of cases after an average interval of 10 years. The world's record for recurrences probably belongs to one poor soul described in a Slovakian medical journal as experiencing 11 relapses!

(C) 2005 by Gary Cordingley

Certainly don’t make fun of person who is hyperventilating, no matter how little or petty it may seem to you, this is clearly not a “little” matter to person suffering. Hyperventilating in “rare” cases can lead to passing out. So please consider welfare of patient. Now get patient to cover his/her mouth and nose with their hand, this way they can feel their breath against their hand so they know they’re definitely breathing. Get them to take much slower deep breaths until they calm down and resume normal breathing.

Note: Never self diagnose. Make sure you visit your local GP first. All material provided is for informational or educational purposes only. No content is intended to be a substitute for professional medical advice, diagnosis or treatment. Consult your doctor regarding applicability of any opinions or recommendations with respect to your symptoms or medical condition.