The difference between Bell’s palsy and a stroke

Bell’s palsy is a temporary paralysis of the facial muscles, causing drooping and weakness on one side of the face. It is sometimes mistaken for a stroke. While alarming, Bell’s palsy is usually temporary and often resolves within two weeks to six months, depending on severity.

“I see patients with Bell’s palsy every year,” says Jyotir Jani, M.D., a Piedmont family medicine physician. “Because Bell’s palsy affects a single nerve, the facial nerve, its symptoms mimic those of a stroke.”

A stroke occurs when blood flow to the brain is blocked or a vessel ruptures. Bell’s palsy involves damage to the facial nerve.

An estimated 40,000 people in the United States will develop Bell’s palsy each year. People of any age can develop it, though it’s less common in those under 15 or over 60. It’s most common in people with upper respiratory infections, like a cold or flu, or those with diabetes.

It is named after Sir Charles Bell, a Scottish surgeon who studied the condition in the 19^th century.

Bell’s palsy symptoms

The facial nerve controls many functions, so damage can cause a range of symptoms that vary in type and severity. They include:

• Paralysis, drooping, weakness or twitching on one side of the face (rarely on both sides)

• Change in the ability to taste

• Difficulty speaking

• Dizziness

• Drooling

• Eye or mouth dryness

• Excessive watering in one eye

• Headache

• Hypersensitivity to sound

• Pain in the jaw or behind the ear

• Ringing in the ears

• Trouble eating or drinking

What causes Bell’s palsy?

Experts aren’t sure exactly what causes Bell’s palsy. One theory suggests a viral infection, like the cold sore virus or viral meningitis, can trigger Bell’s palsy. This happens because the infection causes inflammation of the facial nerve. Antiviral medications may help, but research isn’t conclusive, Dr. Jani says.

Bell’s palsy has also been associated with:

• Chronic middle ear infections

• Diabetes

• Facial injury

• Headaches

• Hypertension (high blood pressure)

• Lyme disease

• Sarcoidosis

• Skull fracture

• Tumors

How is Bell’s palsy diagnosed?

If someone has facial drooping or paralysis, a doctor will first rule out other causes, such as a stroke. Other tests include:

• An electromyography (EMG) test to assess nerve damage

• A blood test to detect diabetes or infection

• An MRI or CT scan to look for damage to the facial nerves

Bell’s palsy treatment

“Bell’s palsy usually improves on its own after a few months,” Dr. Jani says. “Taking Prednisone, a steroid, can increase chances of full recovery, but only if taken within a few days of symptoms starting. Some patients end up with permanent nerve damage or loss of function. Because prednisone may improve recovery, it’s important to seek medical care right away. Also, because symptoms can mimic stroke, it is important to have the condition evaluated.”

If you experience facial drooping or weakness, visit your nearest emergency department to rule out stroke. If you are diagnosed with Bell’s palsy, talk to your primary care doctor about your treatment options.

Dr. Jani practices at Piedmont Physicians Jefferson Family Practice, located at 528 Panther Drive, Jefferson, GA 30549. Schedule an appointment with Dr. Jani or one of our other primary care providers. Save time, book online.

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