Brief Answer: Patience, proper follow up Detailed Answer: Hi and thanks for the query, I am afraid till date, it is difficult to pin point with certainty, the exact cause of Bell's palsy. However, viruses and other inflammatory conditions have been suggested to be at the origin, but its still not very clear. With appropriate treatment started on time, most patients with this condition do recover completely. If started late, some patients make take a longer duration of time to do so than others. Immuno-deficiency does not however explain clearly why your son developed Bells palsy. However, the fact that he is prone to develop more frequent viral infections, due to the immune deficiency syndrome, could suggest this. It is compelling to manage appropriately this immune deficiency state, especially through avoiding recurrent infections. This could be achieved through time clinical evaluations and treatments of any suspected infections, and following an appropriate recommended vaccination schedule. The opinion of an internist and an infectiologist, to chat the main recommended vaccines to be taken could be of great importance. Steroids, especially Prednisolone have produced significant results, as far as management of Bells Palsy is concerned. They should however be taken with caution, to avoid common side effects as immune depression as in his specific case. Other treatment options like Acupuncture have been advocated, and is also used in some treatment centers. It is true that he has had steroids, physiotherapy and antiviral medicines, which of course are appropriate. Recovery rates differ. You might still have to exercise some patients, for recovery could stay quiet longer to come in some patients. It might take up tp a few months in some patients to obtain full recovery. I recommend a proper review with an internist, the opinion of an infectiologist, a proper vaccination chat proposition from these specialist and compliance to treatment. Thanks and kind regards as I wish him the best of health. Dr Bain.

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