Bell’s palsy and a stroke both cause facial weakness, in which one side of the face may droop or sag. Although both conditions require prompt medical attention, a stroke is a medical emergency.
Bell’s palsy and a stroke have some similar symptoms. However, the causes and treatments for each condition differ.
This article explains how to tell the difference between a stroke and Bell’s palsy and when to contact emergency services. It also describes the causes, diagnoses, treatments, and recovery rates for both conditions.
A stroke and Bell’s palsy can both cause paralysis or facial weakness on one side of the face.
Any person who experiences facial weakness should contact a doctor, as a stroke is a medical emergency and
The table below compares
| Bell’s palsy | Stroke | |
|---|---|---|
| Affects the upper face | always | less often |
| Affects the lower face | always | often |
| One-sided facial paralysis | yes | yes |
| Affects speech and vision | not often | often |
| Affects pupils | not often | sometimes |
| Affects the ability to close the eye on the symptomatic side | often | not often |
| Causes sensitivity to sounds | often | not often |
| Causes weakness in the arm or leg | not often | often |
| Causes ear or jaw pain | often | not often |
| Decreases saliva and tear production | often | not often |
| Changes taste | often | not often |
| Symptom progression | within hours or days | within seconds |
| Age group typically affected | 30 to 50 years | 60 years and older |
Differences in facial weakness
Bell’s palsy and a stroke typically affect different facial nerves, which means they may cause facial weakness in different areas of the face.
According to a
Bell’s palsy usually affects facial nerves that cause peripheral facial weakness. This
If a person has or suspects someone else is showing signs of a stroke, they should immediately contact 911. A stroke is a medical emergency that
Signs and symptoms of a stroke occur suddenly. According to the
- F: face droops when a person attempts to smile
- A: arm weakness, in which one arm drifts downward when the person lifts their arms
- S: speech difficulty, in which the person slurs their speech or has difficulty repeating a simple phrase
- T: time to act by contacting 911 if a person has any of the above symptoms
A person should also call 911 if they have symptoms of Bell’s palsy to receive prompt treatment and rule out a stroke. Receiving treatment for Bell’s palsy quickly may improve a person’s symptoms and outcome.
Symptoms of Bell’s palsy include:
- weakness on one side of the face, which may develop over a few days
- a drooping eye or side of the mouth
- a dry or watering eye
- difficulty closing the eye
- dry mouth
- drooling
- a loss of taste
- ear or jaw pain
Bell’s palsy and strokes have different causes.
Bell’s palsy
Compression of the seventh cranial nerve in the face causes Bell’s palsy.
Although the exact cause of this compression is unknown, it may develop as a result of inflammation. This inflammation may affect signals between the facial muscles and the brain, which can result in facial weakness.
Underlying conditions that may
- a dormant viral infection, such as herpes simplex or chickenpox
- impaired immunity as a result of:
- stress
- sleep deprivation
- minor illness
- physical trauma
- autoimmune conditions
- infection and inflammation of the facial nerve due to a condition such as Lyme disease
- damage to the fatty covering, called the myelin sheath, that insulates the nerve fibers
However, Bell’s palsy may occur without a clear cause.
Stroke
Each type of stroke has a different cause:
- Ischemic stroke: A blockage or narrowing in the arteries severely reduces blood flow to the brain.
- Hemorrhagic stroke: A burst artery in the brain leaks blood, which damages brain cells.
There are no specific tests to diagnose Bell’s palsy or stroke. A doctor will perform various examinations and tests to diagnose these conditions.
Bell’s palsy
A doctor will examine the face for upper and lower muscle weakness. They will typically rule out other causes of facial weakness during the examination.
A doctor will
Stroke
A doctor may perform a physical examination and perform or order various tests and scans to diagnose stroke. These include:
- brain scans, such as CT or MRI scans
- blood tests
- heart and blood vessel tests, including an echocardiogram and carotid ultrasound
- swallowing tests, as a person may have difficulty swallowing soon after a stroke
Bell’s palsy and a stroke require different treatments.
Bell’s palsy
Treatment for Bell’s palsy can include:
- corticosteroids, which a doctor may combine with antiviral medication
- surgical tape to help a person keep their eye closed during sleep
- eye drops, such as artificial tears, and ointment to help prevent dry eye
- an antiviral medication, such as:
Learn moreLearn more about how to manage Bell’s palsy and its symptoms:
Stroke
Stroke treatment can involve different medications and surgery.
Medications can include:
- thrombolytic medication to dissolve blood clots
- anticoagulant medication to reduce the risk of further blood clots
- antiplatelet medications, such as aspirin, to reduce the chances of blood clot formation
- statins to reduce cholesterol
- medications to reduce blood pressure
Surgical procedures include:
- Thrombectomy: If a blood clot occurs in a large brain artery, surgeons may perform a thrombectomy. This involves inserting a device through a catheter into the artery to suction or remove the clot.
- Carotid endarterectomy: If fatty plaques build up and cause the carotid artery to narrow, surgeons may perform a carotid endarterectomy. This involves creating an incision in the neck to open the artery and remove the plaques.
- Craniotomy: Doctors may perform a craniotomy to repair damaged blood vessels and remove blood in the brain from a hemorrhagic stroke.
The outlook for a person who experiences Bell’s palsy or a stroke may differ depending on the severity of the person’s condition and how promptly they receive treatment.
Bell’s palsy
According to a
The article refers to research that suggests around 10% of people experience a recurrence of Bell’s palsy within 10 years.
Stroke
Recovery from a stroke
Research suggests that having a stroke may reduce a person’s life expectancy by
One
Bell’s palsy and a stroke both cause facial weakness. However, the conditions have different causes, symptoms, and treatments.
A stroke is a more severe condition than Bell’s palsy and may be life threatening.
Although Bell’s palsy and a stroke often affect different areas of the face, a person should treat any facial weakness as a medical emergency.