Is Bell’s palsy a side effect of COVID-19?

Sandy Harjo-Livingston
·3 min read
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Editor’s note: This story has been updated to correct the attribution of a quote to the original journal publisher.

HONOLULU (KHON) – Getting infect with COVID-19 can result in flu-like symptoms, respiratory issues, brain fog, and in very rare cases temporary facial paralysis.

Bell’s palsy describes an “unexplained episode of facial muscle weakness or paralysis” caused by damage to the facial nerve, according to Johns Hopkins Medicine. Usually the pain or discomfort is isolated to one side of the face. It starts suddenly and then gets worse over a 48-hour period.

Waking up not being able to move the face and suffering through the pain that follows, while still rare, has become a more common experience since the pandemic began. It could be a rare side effect of COVID-19 infection, though scientists say more research is needed.

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“Case reports of Bell’s palsy associated with COVID-19 are emerging, but association does not mean causation,” writes one case study author in American Journal of Ophthalmology Case Reports. “That said, we need to report these cases to draw attention to the possible neuroinvasive propensity of this virus.”

A 2021 study of the connection between Bell’s palsy and COVID-19 found despite the increases, the overall occurrences were still low. Of the 348,088 with COVID-19 identified in the study 284, or 0.08%, were diagnosed with Bell’s palsy within eight weeks of getting sick. About half of those people had a history of Bell’s palsy, while half did not.

The occurrence of Bell’s palsy (BP) was even rare following COVID-19 vaccination, the study found. “This analysis found a statistically significant higher risk of BP in patients with COVID-19 compared with those who were vaccinated against the disease,” it reads. “Further long-term analysis is necessary to determine the relationship between COVID-19 and the COVID-19 vaccine on BP.”

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Another 2021 study found the risk of getting Bell’s palsy after the COVID-19 vaccine was no greater than after other viral vaccines.

The exact cause of Bell’s palsy is unknown, according to Johns Hopkins, but it’s thought to be triggered by inflammation caused by an overactive immune system. That’s why it often occurs in conjunction with a viral infection.

What are the signs of Bell’s palsy? The Mayo Clinic has provided a list:

  • Rapid onset of mild weakness to total paralysis on one side of your face — occurring within hours to days

  • Facial droop and difficulty making facial expressions, such as closing your eye or smiling

  • Drooling

  • Pain around the jaw or in or behind your ear on the affected side

  • Increased sensitivity to sound on the affected side

  • Headache

  • A loss of taste

  • Changes in the amount of tears and saliva you produce – for many, they experience extreme dry eyes to point where they develop sores

(Photo: Getty Images)
(Photo: Getty Images)

According to Johns Hopkins, facial paralysis usually starts to improve in two weeks, but could take months to fully resolve.

Experts recommend speaking to a health care provider if you believe you have Bell’s palsy so you can seek appropriate treatment and care.

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