How to tell Bell’s Palsy from Stroke? ⁠

The symptoms of Bell’s Palsy can be almost identical to Stroke. In fact, even a trained eye may notice similar signs in both conditions like the obvious slurring of speech and drooping of the facial muscles to the side. The pupils of the eye are equal, round, and reactive to light but there’s difficulty closing the eyelid.

It’s easy, at the first look, to misdiagnose both conditions. In fact, many patients with Bell’s Palsy understandably panic believing that they’re experiencing a stroke. While the symptoms are similar for both, a stroke is life-threatening and may have irreversible effects on a survivor’s health. Bell Palsy, on the other hand, is a temporary condition and almost 90% of patients recover from it completely.

So, how can you spot the differences between the two conditions and take steps to ensure the symptoms don’t worsen and timely treatment can be administered? Let’s explore the two in detail.

What is Bell’s Palsy?

Bell’s Palsy is a condition that causes weakness or paralysis of the muscles on one side of the face. In rare cases, it can affect both sides of the face. The condition occurs when the nerve that controls your facial muscles becomes inflamed, swollen, or compressed. The exact cause behind Bell’s Palsy is unknown but in most cases, it is temporary and improves over a few weeks. 

What are the symptoms of Bell’s Palsy?

The signs and symptoms of Bell’s Palsy can occur suddenly and may include:

• Mild weakness to total paralysis on one side of the face
• Facial droop and difficulty closing the eyelid, raising the eyebrow, or smiling on the affected side
• Pain around the jaw or in or behind the ear on the affected side
• Increased sensitivity to sound on the affected side
• Headache
• Drooling
• Loss of taste
• Slurring of speech
• Increased or decreased tear and saliva production

What causes Bell’s Palsy?

While the exact cause of the condition is unclear, medical researchers believe it can be triggered by a viral or bacterial infection. Some of the virus/bacteria that have been linked to Bell’s Palsy include:

• Cold sores and genital herpes (herpes simplex)
• Chickenpox and shingles (herpes zoster)
• HIV
• Sarcoidosis
• Lyme disease
• Infectious mononucleosis (Epstein-Barr)
• Respiratory illnesses (adenovirus)
• German measles (rubella)
• Mumps (mumps virus)
• Flu (influenza B)
• Hand-foot-and-mouth disease (coxsackievirus)
• Cytomegalovirus infections 

In addition to these causes, there are accompanying risk factors — the condition can be seen in people during pregnancy, if they have diabetes, if they have a lung infection, or if they have a family history of the condition.

How is Bell’s Palsy treated?

In most cases, it’s possible to recover from Bell’s Palsy completely without treatment but the severity of the condition remains an important deciding factor. If the doctor decides to go ahead with the treatment they may suggest medication or physical therapy to help speed your recovery.

Medication

Commonly used medications to treat Bell's palsy include:

• Corticosteroids: They are powerful anti-inflammatory agents that can reduce the swelling of the facial nerve
• Antiviral drugs: They may be administered along with steroids to help eliminate the viral infection that may have caused Bell’s Palsy
  

Physical therapy

Physical therapy can help exercise and restore the facial muscles preventing permanent muscle contractures.

Facial Splinting

In addition to medication and physical therapy, doctor’s may deem it necessary to prescribe a customised facial splint. The splint will prevent drooping and contracture of the facial muscles and facilitate recovery.

What is a stroke?

A stroke occurs when there’s a sudden interruption in the flow of blood to the brain. This blockage prevents brain tissue from receiving oxygen and nutrients, causing the brain cells to die. Unlike Bell’s Palsy, a stroke is a medical emergency, and immediate treatment is crucial to reduce brain damage, prevent resultant complications, and even save the patient’s life.

What are the symptoms of a stroke?

If symptoms of a stroke occur, it’s important to pay attention to the time they begin. It could be a deciding factor in providing appropriate treatment and preventing irreversible effects on a patient’s health.

Some signs and symptoms of a stroke may include:

• Paralysis or numbness of the face, arm, or leg
• Dropping facial feature including difficulty in smiling
• Trouble speaking, slurring of words
• Difficulty in hearing speech
• Severe and sudden headache, which may be accompanied by vomiting, dizziness or altered consciousness
• Trouble walking and/or the loss of coordination

What causes a stroke?

A stroke may be caused by either a blocked artery (ischemic stroke) or leaking or bursting of a blood vessel (hemorrhagic stroke). In some cases, there may be only a temporary disruption of blood flow to the brain, known as a transient ischemic attack (TIA).

• Ischemic Stroke: This is the most common type of stroke and is caused by the build-up of fatty deposits or by blood clots that block the blood vessels of the brain.

• Hemorrhagic Stroke: This is caused when a blood vessel in the brain leaks or ruptures. A number of factors may result in a hemorrhagic stroke including:
• Uncontrolled high blood pressure
• Overtreatment with blood thinners (anticoagulants)
• Bulges at weak spots in the blood vessel walls (aneurysms)
• Trauma (such as an accident resulting in a blow to the head)
• Ischemic stroke leading to hemorrhage

• Transient Ischemic Attack (TIA): This occurs when a clot or debris reduces or blocks blood flow to a part of the nervous system. A TIA usually lasts only a few minutes and does not result in permanent damage to the brain.

How is a stroke treated?

Understanding the time and type of stroke is a crucial factor in treatment. The number of minutes passed from the onset of symptoms can help a medical team greatly in deciding the course of action.

The treatment for an ischemic stroke or TIA may involve:

• Antiplatelet and anticoagulants
• Clot-breaking drugs
• Mechanical thrombectomy
• Stents
• Surgery

The treatment for a hemorrhagic stroke may involve:

• Medications
• Coiling
• Clamping
• Surgery

How to tell Bell’s Palsy from a stroke?

Now that we’ve understood the differences between the causes and treatment of the two conditions, let’s solve the problem of diagnoses.

If you, or someone you come across, experience facial paralysis without any other sensory or motor deficits (for example, no loss of movement in the arms or legs) the next thing you need to do is determine which parts of the face are affected. Have the person attempt to raise both eyebrows as if surprised. Then have the patient smile. 

• If they cannot raise their eyebrows and cannot move the lower portion of their face they have Bell's Palsy and should be given steroids or antivirals 
• If the lower portion of their face is paralyzed but the eyebrows rise symmetrically, then they need to be concerned about a stroke and should receive immediate treatment

In both cases seek medical attention immediately and follow a course of action prescribed by experts.

Plexus Rehabilitation Centre in Bangalore aims at tackling disorders by understanding the severity and type of the condition. We offer comprehensive treatment to rehabilitate patients suffering from neurological, psychiatric, and auto-immune conditions. Our experts are trained to understand every patient and the right set of therapies that their condition requires.