Facial Paralysis is NOT Necessarily a Stroke

Facial Paralysis is NOT Necessarily a Stroke

Last Reviewed : 12/18/2020
Facial Paralysis is NOT Necessarily a Stroke

Facial paralysis is one of the common symptoms of stroke. While that may be true in several cases, it is not always true. But just before we go any further, let’s put the meanings of these conditions into perspective.

About Facial Paralysis

As regards its cause, facial paralysis occurs due to the damage to the nerve supplying the facial muscles. It is the facial nerve that supplies the muscles of the face. It originates in the brain and enters the face near the ear and supplies the muscles of the face. Facial paralysis is not necessarily stroke . There are many other conditions that cause facial paralysis.

Causes of Facial Paralysis

There are certain conditions that lead to facial paralysis. These causes include:

  • Bell’s Palsy
  • Any infection or inflammation of facial nerve
  • Trauma
  • Brain tumor
  • Neck tumor
  • Stroke
  • Middle ear infection
  • Lyme disease
  • Auto immune diseases like Multiple Sclerosis and Gullian Barre Syndrome
  • Ramsay Hunt Syndrome (Reactivation of viral infection)

Also known as Idiopathic Facial Paralysis, Bell’s palsy is a facial nerve paralysis of sudden onset. Most times, its cause is not known. It also occurs secondary to viral and bacterial infections, but it is self-limiting. The duration of the paralysis is very brief (about six months). Physiotherapy helps to regain the strength of the muscle.

Facial paralysis of gradual onset, progressive in nature, of longer duration generally denotes a tumor of head or neck. They may be present with additional symptoms, such as headaches, seizures, vertigo, and hearing loss. Hence, it should be evaluated carefully.

Understanding the Disparity

On the other hand, a serious case of facial paralysis is stroke. In stroke, the nerve completely gets damaged, making recovery a difficult task. Deviation of mouth is associated with weakness in the hands and legs.

It is difficult to differentiate facial paralysis due to stroke from Bell’s palsy. Both of these conditions occur all of a sudden. Fundamentally, there is deviation of angle of mouth, drooling of saliva and pooling of food in both conditions. The major difference between stroke and Bell’s palsy is that a complete half of the face is paralyzed in Bell’s palsy whereas upper part of the affected side of the face is partially paralyzed in a stroke.

When the individual with stroke is asked to raise both the eyebrows, he or she may be able to partially raise the eyebrow on the affected side. However, a victim of Bell’s palsy may not be able to raise the eyebrow at all. Keep in mind that inability to blink the eye is usually due to Bell’s palsy. Individuals with stroke may be able to blink eye at least partially.


In conclusion, it’s a crystal clear that facial paralysis doesn’t necessarily mean stroke. You already know that it is pretty difficult to differentiate facial paralysis due to stroke from Bell’s palsy as those two conditions have striking similarities. However, that doesn’t mean there are no differences. More importantly, Bell’s palsy is usually temporal and can be resolved within two weeks to six months. In contrast, stroke ceases blood flow to the brain, which could result in rupture, which takes much longer time. While stroke can be life-threatening, Bell’s palsy is not. These are some of the disparities between the two disorders.

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