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Bell's palsy vs. stroke

Bell’s Palsy vs. Stroke

Bell’s palsy and stroke both affect facial muscles, but are distinct conditions that differ in symptoms, severity, and recovery. Recognizing the unique signs of these conditions is vital for seeking timely and appropriate medical care.

Understanding Bell’s Palsy

Bell’s palsy is a condition that affects facial muscles, resulting in temporary weakness or paralysis on one side of the face. The exact cause is unknown, but experts think that this occurs when the facial nerve, which controls muscles of the face, becomes swollen or inflamed. This may happen after a viral infection or because of an immune system response. There may also be a genetic predisposition.

Bell’s palsy symptoms develop quickly and generally begin to improve within a few weeks. Complete recovery is typically within six months, although some people experience long-term symptoms. 

The signs of Bell’s palsy may include:

  • Sudden Symptoms: Bell’s Palsy often comes on suddenly, with symptoms developing rapidly over a few hours to a day.
  • Facial Weakness or Paralysis: Weakness or paralysis on one side of the face, causing drooping or difficulty in facial expressions.
  • Drooping Mouth or Eyelid: The affected side of the face may droop, making it challenging to close the eye or smile.
  • Loss of Taste: Some individuals may experience a loss of taste on the front two-thirds of the tongue.
  • Increased Sensitivity to Sound: In some cases, sensitivity to sound in the ear of the affected side may occur.

Recognizing Stroke Symptoms

When a stroke occursblood flow to a part of the brain is disrupted, either due to a blockage or bleeding. The lack of blood and oxygen can lead to damage or death of brain cells. Recognizing the symptoms promptly is crucial for seeking immediate medical attention

Common signs of a stroke include:

  • Sudden Numbness or Weakness: Sudden numbness or weakness, especially on one side of the body, may affect the arm, leg and/or face.
  • Confusion or Trouble Speaking: Difficulty speaking, slurred speech, or sudden confusion are indicators of a potential stroke.
  • Trouble Walking or Coordination Issues: A sudden onset of balance problems, dizziness, or difficulty walking could be a sign of a stroke.
  • Severe Headache: A sudden, severe headache with no known cause may occur, especially if accompanied by other signs.

When you are looking for early warning signs of stroke, remember the acronym BE FAST:

  • B: Balance or coordination issues
  • E: Eyesight becomes blurred or reduced
  • F: Face drooping
  • A: Arm (and leg) weakness
  • S: Speech difficulty
  • T: Time to call emergency services

Recognizing these symptoms and taking swift action by seeking emergency medical assistance is crucial for minimizing potential damage and improving outcomes in the event of a stroke.

Bell’s Palsy vs. Stroke

While both Bell’s palsy and stroke can affect facial muscles, they are distinct conditions with different causes, symptoms, and treatments

Here are key differences between the two:

1. Causes

  • Bell’s Palsy: Linked to viral infections, immune response and genetics
  • Stroke: Caused by a disruption of blood flow to the brain, often due to a blood clot or bleeding

2. Onset and Progression

  • Bell’s Palsy: Typically has a sudden onset, and symptoms peak within 48 hours; often shows improvement within three weeks and complete recovery within six months
  • Stroke: Symptoms may appear suddenly and can vary in intensity; progression depends on the type of stroke and how quickly medical intervention is sought

3. Numbness or Weakness

  • Bell’s Palsy: Primarily affects one side of the face, causing weakness or paralysis
  • Stroke: Weakness may occur on one side of face, arm or leg

4. Additional Symptoms

  • Bell’s Palsy: Typically limited to facial muscle weakness, drooping and changes in taste
  • Stroke: Can involve a broader range of symptoms, including garbled or nonsensical speech and coordination issues

5. Treatment

  • Bell’s Palsy: Typically involves corticosteroids (anti-inflammatory medications), antiviral medications, and/or physical therapy
  • Stroke: May include clot-busting medications (for ischemic strokes), antiplatelet drugs (to stop blood clots from forming), and, in certain cases, surgery to dissolve or remove clots

6. Recovery

  • Bell’s Palsy: Generally has a good prognosis, with majority of individuals recovering fully
  • Stroke: Recovery varies and depends on the severity of the stroke and promptness of medical intervention

It’s crucial to consult with a healthcare professional for a proper diagnosis, as the two conditions require different approaches to treatment and management. If facial weakness or other concerning symptoms arise, seeking prompt medical attention is essential to determine the underlying cause and receive appropriate care.

  • Michael Guido, MD
    Co-Director, Stony Brook Comprehensive Cerebrovascular & Stroke Center
    Director of Clinical Neurophysiology Fellowship
    Assistant Director of the Neurology Residency Program

    Dr. Michael Guido is trained to treat all neurological disorders. He is board certified in Neurology, Vascular Neurology and Clinical Neurophysiology, and has special clinical interests in Vascular Neurology conditions including Strokes.

This article is intended to be general and/or educational in nature. Always consult your healthcare professional for help, diagnosis, guidance and treatment.