While searching the web, you might start asking yourself: are facial palsy and Bell’s palsy the same? What is the difference between them? To answer this in short: Bell’s palsy is a type of peripheral facial palsy. Let’s go over this in more details.
Note: This article is also available in a video format in our Bell’s Palsy Video Courses.
What is facial palsy?
Facial palsy is a general term used to describe any kind of paralysis of facial muscles. It can be of a central or a peripheral origin.
Central facial palsy
Central facial palsy happens when certain structures of the brain get damaged. One of the most common causes for this is a stroke. In this case, the symptoms of facial palsy will be limited to the lower half of the face. For example, if you had a stroke, you might not be able to move your mouth corner, but you will be able to raise your eyebrows and blink normally.
Peripheral facial palsy
Peripheral facial palsy leads to complete paralysis of one side of the face. So if your facial muscles on the affected side are paralysed on both upper and lower part, then you can relax, as it is not a symptom of a stroke. In our clinic, we focus mostly on working with peripheral facial palsy.
Causes of peripheral facial palsy
Peripheral facial palsy can have several causes. Each of them may cause different damages to the nerve fibres. Since the level of the damage is different, the prognosis for recovery will also depend on the cause. Below are some of the most common causes of peripheral facial palsy:
• Ramsay Hunt Syndrome – comes from herpes zoster virus. Usually, it causes a high level of damage to the facial nerve and recovery may take a longer time, leading to complications and residuals.
• Lyme disease – derives from Borrelia type of bacteria, which we get mostly from the tick bite. In this case, the damage may also be severe and the recovery may take a longer time.
• Otitis media – inflammation of the middle ear. The inflammation may lead to swelling that causes damage to the facial nerve. The level of the damage may vary.
• Tumors of various types, including acoustic neuroma.
• Iatrogenic damages – damages incurred during surgical interventions in the area.
• Trauma – temporal bone fractures and other injuries involving temporal and zygomatic areas of the face.
• Bell’s palsy – often results from local over-cooling of face, head and neck area from cold weather, wind, air-conditioning, drafts (driving with both windows open). Additional risk factors are stress, hypertension, last weeks of pregnancy. Some sources also name diabetes as a risk factor.
So what is Bell’s palsy?
Essentially, Bell’s palsy is a diagnosis of exclusion for peripheral facial palsy. If none of the known causes can be confirmed, then the facial palsy is considered idiopathic, i.e. “from unclear or undetermined causes”. In other words, if the causes of your facial palsy cannot be determined and confirmed, the diagnosis will be “Bell’s palsy”.
