What to do if I woke up with symptoms of Bell's (Bell's palsy)?

Bell's Palsy Management: Immediate Steps

If you wake up with symptoms of Bell's palsy, you should seek medical attention promptly and start oral corticosteroids within 72 hours of symptom onset for the best recovery outcomes. 1, 2

Immediate Actions

1. Seek medical attention within 72 hours - This timeframe is critical for optimal treatment effectiveness 1, 2

2. Expected medical management:

   • Oral corticosteroids - The primary treatment strongly recommended by guidelines 1, 2
   • Typical regimen: Prednisone 50-60mg daily for 5 days followed by a 5-day taper 3
   • Optional antiviral therapy may be added to steroids (not as monotherapy) 1, 2

3. Implement eye protection immediately if you cannot fully close your affected eye:

   • Use artificial tears during the day
   • Apply ocular ointment at night
   • Consider eye patching or taping 2

What to Expect During Medical Assessment

Your healthcare provider should:

• Take a thorough history to rule out other causes of facial weakness
• Perform a physical examination focusing on facial nerve function
• Assess your ability to close your eye, raise your eyebrow, and smile 1

What NOT to expect:

• Routine laboratory testing is not recommended 1
• Routine diagnostic imaging is not recommended 1

Prognosis and Follow-up

• 70-94% of patients recover completely, even without treatment 2
• Recovery typically begins within 3 weeks and continues for 3-6 months 4, 5
• You should be reevaluated if:
  • You develop new or worsening neurologic findings
  • You have incomplete recovery after 3 months 1, 2

Important Considerations

• Early treatment is critical - The effectiveness of treatment diminishes significantly if started after 72 hours 2

• Risk factors that may affect your recovery:

  • Diabetes
  • Pregnancy
  • Compromised immune system
  • Complete facial paralysis (vs. partial) 2, 5

• Warning signs that require immediate medical attention:

  • Bilateral facial weakness (extremely rare in Bell's palsy)
  • Other neurological symptoms (could indicate stroke)
  • Gradual onset over weeks (could indicate tumor) 2

Common Pitfalls to Avoid

1. Delaying treatment beyond 72 hours - This significantly reduces treatment effectiveness

2. Neglecting eye care - Inadequate eye protection can lead to corneal damage, which can be permanent

3. Using antiviral medication alone - Antivirals should only be used in combination with steroids, never as monotherapy 1, 3

4. Assuming all facial weakness is Bell's palsy - Other serious conditions like stroke can cause facial weakness but typically spare the forehead 2, 3