From the Guidelines
Temple pain and crawling sensations can occur with Bell's palsy, though they're not among the most commonly reported symptoms. Bell's palsy typically presents with facial weakness or paralysis on one side, but many patients also experience pain around or behind the ear, which can radiate to the temple area 1. This pain often precedes the facial weakness by 1-2 days. The crawling or tingling sensation some patients describe is related to nerve irritation as the facial nerve becomes inflamed in the narrow bony canal it passes through.
Some key points to consider about Bell's palsy include:
- Ipsilateral pain around the ear or face is not an infrequent presenting symptom 1
- The facial nerve carries nerve impulses to muscles of the face and also to the lacrimal glands, salivary glands, stapedius muscle, taste fibers from the anterior tongue, and general sensory fibers from the tympanic membrane and posterior ear canal 1
- Patients with Bell’s palsy may experience dryness of the eye or mouth, taste disturbance or loss, hyperacusis, and sagging of the eyelid or corner of the mouth 1
- Standard treatment includes corticosteroids like prednisone (typically 60-80mg daily for 5-7 days, then tapered) started within 72 hours of symptom onset to reduce inflammation and improve recovery outcomes 1
If you're experiencing Bell's palsy, it is crucial to start treatment with corticosteroids within 72 hours of symptom onset. Eye protection is also essential if you cannot fully close your affected eye - use artificial tears during the day and lubricating ointment with eye taping at night to prevent corneal damage. While these temple sensations are not unusual, persistent or severe pain should be evaluated by a healthcare provider to rule out other conditions.
From the Research
Symptoms of Bell's Palsy
- The provided studies do not specifically mention temple pain and crawling sensation as common symptoms of Bell's palsy 2, 3, 4, 5, 6.
- However, Bell's palsy is characterized by unilateral facial weakness, reduced forehead wrinkling, nasolabial fold flattening, drooping of the corner of the mouth, and drooling 3.
- The condition can cause physical and psychological complications and negatively impact patients and their relatives 2.
Diagnosis and Treatment
- Bell's palsy is a diagnosis of exclusion, with treatments ranging from corticosteroids to antivirals, to a combination of both corticosteroids and antivirals, to acupuncture, physical therapy, and chiropractic 3.
- Corticosteroids have been shown to be effective in increasing the likelihood of recovery from Bell's palsy, especially when used shortly after the onset of the condition 4, 5, 6.
- The optimal treatment approach for patients with Bell's palsy remains unclear, but steroid monotherapy and combined steroid and antiviral therapy have been shown to be effective in different scenarios 6.
Recovery and Prognosis
- Most patients with Bell's palsy will recover fully within six months, regardless of the treatment 3.
- The recovery rate can be influenced by factors such as age, electroneurography (ENoG) and electromyography (EMG) results, and comorbid conditions 6.
- Initiating treatment within 72 hours of the onset of Bell's palsy has been shown to be associated with higher recovery rates 6.