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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, and is sometimes mistaken for a stroke. While alarming, Bell’s palsy is usually not permanent and resolves itself in two weeks to six months, depending on the 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 is caused by a blood clot that stops blood flow to the brain or by a blood vessel that ruptures in the brain, while Bell’s palsy is linked to facial nerve damage.

An estimated 40,000 people in the United States will develop Bell’s palsy each year. Men and women of any age are at risk, though it is not as common in people under the age of 15 or over the age of 60. It seems to be most common in people who have upper respiratory infections (like a cold or the flu) or those who have diabetes.

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

The symptoms of Bell’s palsy

The facial nerve controls a complex array of functions, so when it is damaged, the symptoms can 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 is that a viral infection — like the cold sore virus or viral meningitis — can trigger Bell’s palsy because it causes inflammation to the facial nerve. Antiviral medications may help, but research isn’t conclusive, says Dr. Jani.

Bell’s palsy has also been associated with:

How is Bell’s palsy diagnosed?

If a person has facial paralysis or drooping, a doctor will first rule out other causes of facial weakness, such as 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,” says Dr. Jani. “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 chances for full recovery, it is important for patients to come in immediately to seek medical attention. 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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