Fast Five Quiz: Bell Palsy and Other Facial Paralysis

Helmi L. Lutsep, MD


February 27, 2020

If the paralysis involves only the lower portion of the face, a central cause should be suspected (ie, supranuclear). If the patient complains of contralateral weakness or diplopia in conjunction with the supranuclear facial palsy, a stroke or intracerebral lesion should be strongly suspected.

Many patients with Bell palsy report numbness on the side of the paralysis. This may be secondary to involvement of the trigeminal nerve but may be due to lack of mobility of the facial muscles and not lack of sensation.

Early symptoms of Bell palsy may include:

  • Weakness of the facial muscles

  • Poor eyelid closure

  • Aching of the ear or mastoid (60%)

  • Alteration of taste (57%)

  • Hyperacusis (30%)

  • Tingling or numbness of the cheek/mouth

  • Epiphora

  • Ocular pain

  • Blurred vision

Read more about the presentation of stroke.


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