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Warning-sign checks

Bell palsy: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services if facial weakness occurs with arm or leg weakness, speech difficulty, severe imbalance, confusion, sudden vision loss, or another possible stroke symptom.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact the treating clinician sooner if symptoms worsen, new neurological symptoms appear, or the diagnosis seems uncertain.

    A new rash around the ear, increasing ear pain, hearing loss, severe dizziness, fever, or weakness on both sides of the face also deserves prompt reassessment.

    Arrange urgent eye care for eye pain, redness, light sensitivity, blurred vision, or continued difficulty protecting the eye.

  3. 3

    Does any of this apply?

    Book an appointment

    Routine follow-up may be used to check facial movement, eye closure, medicine effects, and signs of recovery.

    Improvement may begin within weeks, but nerve healing can continue for months.

The article also says

Specialist assessment may be appropriate if facial weakness progresses beyond the expected early period, returns after recovery, or has not begun to improve.

Clinical guidance also recommends reassessment or referral when recovery remains incomplete after about three months.

Depending on the findings, the person may be referred to an ear, nose, and throat specialist; neurologist; eye specialist; or facial rehabilitation therapist.

Every sign above is quoted from the sofidex article on Bell palsy. If you are not sure, err upward — it is always reasonable to be checked.