The symptoms appear very suddenly over a period of a few hours. Paralysis is usually complete within 24 hours, although the symptoms can worsen for a few days, but no longer than 2 weeks.
Typically it begins with some earache and pain behind the ear. A tingling sensation on one side of the face and eye discomfort.
At its peak typical symptoms are:
- Weakness or full paralysis of one side of the face, including the forehead.
- Inability to close the eye (or a definite weakness to the blink in milder cases), resulting in tearing.
- Lack of tears.
- Sensitivity to light.
- Slurred speech.
- Inability to whistle.
- Some facial swelling.
- Diminished taste sensation (a metallic or salty taste is often reported).
- Sounds may appear sharper on the affected side (hyperacusis).
- Some facial numbness may be reported due to interactions from the 5th cranial nerve.
- The corner of the mouth may droop. This can cause some minor drooling and difficulty with drinking.
- Runny or blocked nose.
- Excess or lack of saliva.
- Ear pain (often behind the ear).
- A bruised to the touch feeling in particular spots on the face.