Bell’s palsy is a unilateral paralysis of facial muscles. It can have different causes and names (for simplicity, we will use Bell’s palsy to describe any form of peripheral facial palsy).
When you are just hit by Bell’s palsy, your recovery will follow two of the most probable scenarios: quick recovery or long-term recovery.
The quick recovery usually takes 2 to 3 weeks and, in most cases, leads to full spontaneous recovery. Development of complications and residuals is quite unlikely unless your recovery took a little bit longer.
The long-term recovery can last for several months. As a result, the chances of developing complications and residuals are very high. We discuss this recovery scenario in more detail in the article: “Long Bell’s palsy recovery timeline“.
In this article, we will discuss the details of quick recovery after acute Bell’s palsy.
The contents of this article are based on our experience with numerous patients that visit our clinic for rehabilitation, sign up for a video consultation, or contact us for more information on their cases. The information below is meant to describe the most typical scenario. Each facial palsy case is very unique and will unfold in an individual way. Nonetheless, you can reasonably expect your recovery to follow the direction described here.
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Estimated reading time: 10 minutes
When to expect a quick recovery?
Statistically, quick Bell’s palsy recovery happens in 70-85% of cases. So, in the majority of cases, the prognosis for recovery is very positive. The quick recovery typically takes place within 2 to 3 weeks. By the end of this time, you should see a full spontaneous recovery.
Based on our experience, if you notice some signs of recovery (twitching, itching, vibration, some tiny movements, return of tonus, etc.) within the first week of your facial palsy, then you are most likely going to have a quick recovery.
However, if within the first two weeks since the onset of Bell’s palsy you did not notice any changes or improvement, the probability is very high that your recovery will take a longer time.
What does quick recovery depend on?
The length of recovery after Bell’s palsy depends mostly on the extent of the damage to the facial nerve.
Here it is important to familiarize yourself with the anatomy of the facial nerve. The two most important parts of the facial nerve that we need for this explanation are axon and myelin sheath.
The axon is a branch of the motor neuron that conducts electrical signals sent from the brain to the muscles. In simple words, it is a “highway” on which the signals cross from the brain to the muscles.
Myelin sheath is an electrical insulation that surrounds each axon. Just like any other electrical wire always has an outer insulation tube around it.
As we discuss in more detail in another article “About Bell’s palsy and its recovery“, the damage to the nerve can either be superficial (light), or extensive (deep).
Quick recovery happens if the damage was superficial:
If the damaging factor that caused your Bell’s palsy did not persist for a long time (less than 4-6 days), then most likely, only the myelin sheath is damaged. The axon, remains whole and undamaged.
When the myelin sheath sustains damage, it leaves the axon of the nerve without electrical insulation. So the nerve is unable to supply the electrical signals to the facial muscles. This is known as a conduction block. As a result, the muscles do not receive any contraction signals, so they do not move.
As a comparison, extensive damage injures both the myelin sheath and the axon. This scenario we discuss in the article about the long Bell’s palsy recovery process.
The myelin sheath recovers much quicker than the nerve fibres in our body. It needs somewhere between 1 and 3 weeks for recovery. Once the myelin sheath is restored, the signals are able to reach the muscles again and your movements return. Because the axons were not damaged, the recovery is usually full and without any complications.
What to do to ensure a quick recovery?
If you want to increase your chances for a full recovery, it is important to seek professional help as soon as your facial palsy begins. The goal here is to get rid of the damaging factor as soon as possible, to prevent any damage to the axon. So see your doctor right away. He or she will determine the cause of your facial paralysis and will prescribe any necessary medications.
Although it is extremely important to act directly, it does not guarantee that the damage will be superficial. Steroids, anti-inflammatory, anti-viral and other drugs will help you to combat the cause, but they still need time to work. Also, the damage begins before you experience the symptoms (lack of facial movements). Nonetheless, the quicker you act, the higher your chances for a quick recovery will be.
Quick Bell’s palsy recovery timeline
Here we are describing the optimal recovery scenario. It may vary from person to person. Nonetheless, in the majority of quick recovery cases, you can expect to follow this timeline.
In this timeline, we use photos of a fellow Bell’s palsy sufferer – Jay – who documented the whole recovery process from day 1 using Neurological tests. He has kindly given us permission to use his photos to illustrate the recovery process, in hopes to help those who are suffering from facial palsy to follow his example and stay calm and positive. Please, do not reuse these photos without Jay’s permission.
Your facial palsy begins and the full paralysis of one side of the face takes place. This happens due to conduction block resulting from damaged myelin sheath.
What to do: go to your doctor or the ER as soon as possible. The damaging factor (swelling, viral or bacterial infection, etc.) has to be eliminated as fast as possible to prevent heavier damage to the facial nerve. The doctor will usually prescribe steroids, and in some cases, anti-viral medications. Follow your doctor’s instructions, take a lot of rest, sleep enough.
This time is very hard emotionally, but please do not panic or despair. This will not last forever. Educate yourself about facial palsy. The knowledge will help you to remain calmer and stress less over the situation.
Day 2 to day 5.
Most likely, there will still not be any visible movements.
What to do: continue taking medication as prescribed by your doctor. Be patient, the recovery may take some time. Read our knowledge base. Do soft facial massages, apply warm compress and refrain from stress (emotional and physical).
Day 6 to day 10.
Somewhere around these days, the first signs of recovery should appear. It can be some tingling, tickling, vibrating sensations in your facial muscles. The tonus of the facial muscles can start to return (the face will appear less droopy). Most likely there will not be any noticeable movements yet.
What to do: continue what you were doing before.
Day 11 to day 15.
The first movements should appear. Facial palsy now ends. You are entering the recovery period. It may still take some time for the myelin sheath to recover fully. At this stage, after you see the first movements, the rest of the movements should return within the next 10 days approximately.
If the first movements did not appear by now, then most likely, you are following a long recovery process.
What to do: continue what you were doing before, with the emphasis on more regular massages. Avoid forcing your face into facial expressions to see if you can make it move. Keep your facial muscles relaxed as much as possible. The movements will come when the facial nerve recovers sufficiently. Until then, no matter how much you try, you will not be able to force your muscles to move (the signals from the brain cannot pass to the facial muscles, no matter how strong the signals are).
Day 16 to day 21.
By the end of 3rd week, you should achieve full recovery and your facial muscles should regain their normal functions.
If within 3 weeks from the onset of your Bell’s palsy you have seen very little or no return of facial movements, then most likely, your nerve has sustained a more extensive damage and your recovery follows a long scenario (detailed information is coming soon).
At the end of the recovery, you should not develop any complications or residuals, if your recovery followed this quick scenario. The recovery can range between any amount of time. However, if the first signs of movements did not appear within the first 2-3 weeks, some form of complications or residuals is highly likely to occur. If this is your case, please, do not despair. Complications, such as synkinesis, tensions and contractures of facial muscles, asymmetric smile, etc., are not a life sentence. It is possible to reduce them. We have developed our Neuro-Proprioceptive Rehabilitation method specifically for this, and have been able to help many patients to bring their smile back.
Is it possible to know directly which scenario your recovery will follow?
Unfortunately, presently there are no technical aids or tools that make it possible to measure the depth of initial damage immediately after the onset of facial palsy. The only “forecast” about the extent of your recovery is the time when the first signs of recovery appear. You have to stay patient, hopeful, and positive. Make sure you do what is in your power to provide the optimal recovery condition for your body to support its regenerative efforts.
If you are panicking and feel desperate, please reach out to us or register for an online video consultation, where we can walk you through your recovery process and explain in more detail what is happening to you and what you can expect.
– Alex Pashov
Crystal Touch Bell’s palsy clinic