18/08/2020
Facial Palsy:
Paralysis of facial muscles is generally called Facial Palsy. It can be of a central or a peripheral origin.
1️⃣Central facial palsy happens when certain structures of the brain get damaged by for example, a stroke. The main symptomatic difference between central facial palsy and the peripheral one is that in the former case the upper side of the face is almost not affected. The patient can close both eyes and can blink normally.
2️⃣Peripheral facial palsy leads to a complete paralysis of (mostly) one side of the face.The nature of damages to the nerve fibers and the prognosis for recovery is also different depending on the causes.
➡️• Ramsay Hunt syndrome: comes from herpes zoster virus
➡️• Lyme disease: derives from borellia type bacteria, which we get mostly from the tick bite
➡️• Otitis media (inflammation of the middle ear)
➡️• 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, airco, 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.
Bell's Palsy:
Bell’s Palsy is the most common form of facial paralysis, and is caused by inflammation of the facial nerve, and is most likely related to reactivation of a virus known to cause cold sores (Herpes Simplex Virus). This swelling prevents the nerve from sending correct signals to the brain and facial muscles, resulting in paralysis. Bell’s Palsy can occur very quickly, with symptoms and paralysis setting in as quickly as 48 hours.
⚠️Difference:
⛔The main difference between facial paralysis and Bell’s Palsy is that when a patient is diagnosed with facial paralysis, a cause for the paralysis can be identified, be it a tumor, infection, or nerve damage.
⛔In cases of Bell’s Palsy, the disorder appears without any reason, which can be quite troublesome for the afflicted patients.
⛔Both involves facial nerve.. But, the difference is bell's palsy (LMN type) occurs at the Level of stylomastoid foramen - hence there is ONLY symptoms of paralysis of facial muscles ipsilaterally.
⛔Whereas, facial nerve palsy is a broad term ( includes UMN type as well as LMN type of palsy)..
🔑In LMN type of facial nerve palsy, IF nerve is injured above stylomastoid foramen, then obviously in addition to features of facial muscle paralysis, there is also HYPERACUSIS and INABILITY TO SENSE TASTE SENSATION IN ANTERIOR 2/3 rds OF TONGUE.
In LMN type of palsy, if nerve is injured at the Level of stylomastoid foramen - it is called bell's palsy..!
🔑In UMN type of facial nerve palsy, all the above symptoms are present but, EYES ARE UNAFFECTED ( both eyes can be closed nicely)
⛔In Bell's palsy there is inflammation around the facial nerve and this pressure causes facial paralysis on the affected side.
⛔Facial nerve palsy is the most common acute condition involving only one nerve, with Bell's palsy being the most common cause of acute facial paralysis.
