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 23 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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