"I couldn't blink for half a year": The innovative treatment that helped with Bell's palsy
Facial paralysis that appears within hours can be a traumatic event, and one that requires medical investigation. For 76-year-old Tal, the struggle began one morning when he woke up and discovered that half of his face was paralyzed. After months of pain and an inability to blink, and after drug treatment that he said did not bring improvement, he turned to photobiomodulation — the use of low-intensity light, which has been studied in recent years as a rehabilitation option for people dealing with Bell's palsy.
Facial paralysis that appears within hours can be a traumatic event, and one that requires medical investigation. For 76-year-old Tal, the struggle began one morning when he woke up and discovered that half of his face was paralyzed. After months of pain and an inability to blink, and after drug treatment that he said did not bring improvement, he turned to photobiomodulation — the use of low-intensity light, which has been studied in recent years as a rehabilitation option for people dealing with Bell's palsy.
"My eye remained open for half a year"
Tal initially turned to a doctor at the HMO and received cortisone and other medications. Later, he also consulted with a specialist, but according to him, his condition did not improve. "I suffered from severe pain in my face and ears, I couldn't function, my eye remained open for half a year without the ability to blink," he recalls. Later, he reached Dr. Sagit Baton, an expert in oral medicine and laser at the Malikov Center for Neurology and Advanced Medicine. "She explained to me that in recent years, more and more studies have been published indicating that medical laser treatment may have a role in the rehabilitation of facial nerves. I told myself I had nothing to lose. Today I can say that she saved my face. Within a few treatments, the pain disappeared and no sign of paralysis remained," says Tal. It is important to emphasize that this is the personal testimony of a patient, which in itself is not proof of the effectiveness of the treatment.
What is Bell's palsy?
Bell's palsy is a sudden paralysis or weakness of the muscles on one side of the face, caused by damage to the facial nerve. In most cases, it is not possible to identify an unequivocal cause, and therefore it is defined as idiopathic peripheral facial paralysis. Symptoms can develop within hours to days and include drooping of the side of the face, difficulty smiling and facial expressions, drooling, and difficulty closing the eye on the affected side. Sudden facial paralysis is not a condition that should be diagnosed alone. Facial symptoms can also appear in other medical conditions, and therefore medical evaluation and ruling out other causes for paralysis are necessary. In Tal's case, the injury was also manifested by an inability to blink for a prolonged period. The ability to close the eye is especially important: when the eyelid does not close completely, the eye may dry out and the cornea may be damaged.
Accepted treatment: steroids and eye protection
Treatment for Bell's palsy focuses first and foremost on attempting to restore facial nerve function and reduce the risk of prolonged damage. According to medical guidelines, steroids are usually the primary treatment in adults, with early initiation of treatment being important for recovery chances. In some cases, antiviral treatment is also combined, depending on the patient's condition and the medical team's assessment. When the paralysis is severe or lasts for a long time, the rehabilitation process may also include physiotherapy and facial muscle exercises.
Light treatment: what is photobiomodulation?
The treatment Tal received is called photobiomodulation; it involves the use of low-intensity light using a medical laser or LED lights, in the red and near-infrared light ranges. According to Dr. Baton, the energy is absorbed by cells and affects biological processes related to cellular energy production, inflammation reduction, pain relief, and the encouragement of tissue and nerve repair and healing processes. Unlike a surgical laser, the treatment is not based on heating or destroying the tissue.
Photobiomodulation has also been studied in the context of Bell's palsy. A meta-analysis published in 2024 that included 12 studies and 597 patients found improvement in measures of facial paralysis severity, facial symmetry, and facial function among patients who received laser treatments compared to control groups. Another systematic review from 2024 reached encouraging conclusions regarding facial muscle function, pain, and muscle strength, but the researchers themselves emphasized the great variability between the studies — among other things in wavelengths, dosages, and treatment protocols — and determined that well-planned randomized studies and uniform protocols are required to establish the findings.
Promising treatment — but not yet a substitute for accepted treatment
Despite the encouraging results in some studies, it is important to know that photobiomodulation is not currently considered a substitute for the accepted medical treatment for Bell's palsy. A clinical evidence review by the AAFP determined that there is not yet evidence proving that laser treatment is more effective than standard medical treatment. That is, the new scientific literature points to therapeutic and rehabilitation potential, but additional studies are still required to determine in which patients the treatment is particularly beneficial, what the optimal protocol is, and what its long-term effect is.
"The key to success is the diagnosis"
Photobiomodulation is also applied in the field of facial pain, jaw pain, and migraines. Facial pain can stem from a variety of conditions, including muscle tension, teeth grinding, jaw joint disorders, and pain of nerve origin — and therefore diagnosing the source of the pain is a significant step before choosing the treatment. "More and more patients are looking for non-invasive solutions that are not based only on prolonged drug treatment. The key to success is the diagnosis, patient selection, and precise adaptation of the treatment protocol," concludes Dr. Baton. Tal's case presents a positive result after photobiomodulation treatment, but it also emphasizes a broader point: in sudden facial paralysis, the first step is not choosing an innovative treatment but a quick medical diagnosis, early treatment, and eye protection. Only after that can one examine, depending on the patient's condition and in consultation with professionals, additional rehabilitation options.
