Facial palsy and Stroke

Facial palsy and Stroke


Most common cause of one-sided facial nerve paralysis


[A] Stroke
[B] Accidents
[C] Bell palsy
[D] Cerebellopontine angle tumor



56 year male patient with history of diabetes and systemic hypertension presented with unilateral facial palsy and loss of taste sensation in the anterior 2⁄3 of the tongue on the affected side. What is the most common possible cause


[A] SLE
[B] Cerebro Vascular Accident
[C] Bell palsy
[D] Cerebellopontine angle tumor



Most common cause of facial weakness


Bell palsy – lacrimation and taste are typically affected as well—a fact that can be

Differential diagnosis –


Weakness predominates while lacrimation and taste are intact – Then consider following differential diagnosis


  • Facial nerve is affected more distally after its exit from the skull base via the stylomastoid foramen
  • Facial nerve is affected proximally within the brainstem – intramedullary fascicle (fascicular lesion) or in the facial nerve nucleus itself (nuclear lesion).

  • The most common cause of facial weakness is damage to the facial nerve in the petrous canal:
  • Bell palsy
  • Caused by a viral infection [ probably ]
  • Viral infection Leads to – Inflammatory swelling of the nerve
  • Inflammation and swelling of nerve – Leads to pressure on the nerve in the canal which cause ischemia.
  • This disorder called as idiopathic or crypto genic facial nerve palsy (Eponym – Bell palsy)


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