Recurring Bell’s palsy
The majority of people who develop Bell’s palsy will only get it once in their lifetime. Many people are concerned that they may get another episode of Bell’s palsy but this is unlikely. Research suggests that approximately 2 – 9% of people who develop Bell’s palsy are likely to experience a second episode.
Some people who have more than one episode of Bell’s palsy may have an underlying condition which is causing the recurrence. If you do develop Bell’s palsy more than once your GP or diagnosing clinician should refer you for further investigations so that any underlying problems can be excluded or identified and treated.
In 70% of cases of recurrent facial palsy, the first recurrence occurs within the first ten years. It can recur on the same side or on the previously unaffected side.
Underlying causes
- High blood pressure, diabetes and tumours all of which can cause compression of the facial nerve.
- Recurrent episodes of facial paralysis may be familial. Taking a detailed family history is a crucial part of the assessment in a person with recurring facial palsy.
- Untreated Lyme disease (a bacterial infection caused by a tick bite).
- A benign, undiagnosed tumour on the facial nerve, which mostly goes undetected (facial schwannoma). These types of tumours are tiny and mostly harmless. They grow extremely slowly which is why they are sometimes undetected. Very occasionally they may swell causing pressure on the facial nerve. A diagnosis of Bell’s palsy may be made in the first instance because the presentation is similar and treatment with steroids will reduce the swelling and the symptoms.
- There are several rare conditions that are difficult to diagnose, a symptom of which may be Bell’s palsy.
- One rare condition which causes recurring facial palsy is Melkersson-Rosenthal Syndrome. It is generally accompanied by swelling of the lips, face and tongue.
- Bell’s palsy may recur because of a possible anatomical irregularity of the facial nerve which makes it more vulnerable to injury.
What you should do
Seek medical attention immediately. Starting a course of steroids within the first 72 hours of the onset of symptoms remains the first line of treatment. Your GP or diagnosing clinician should refer you for an MRI and to a neurologist for further examination/assessment.
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