Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Bell's palsy differential diagnosis
Introduction
Overview
Overview
Bell’s palsy must be differentiated from other diseases that cause weakness or total paralysis on one side of the face, difficulty making facial expressions in one side, impaired facial nerve reflexes, salivation and unintended eye closure, such as Ramsay-Hunt Syndrome, Lyme Disease, stroke, Skull fracture, head or neck tumor, and Multiple sclerosis.
Differentiating Bells palsy from other Diseases
Differentiating Bells palsy from other Diseases
- Bell’s palsy must be differentiated from other diseases that cause weakness or total paralysis on one side of the face, difficulty making facial expressions in one side, impaired facial nerve reflexes, salivation and unintended eye closure, such as Ramsay-Hunt Syndrome, lyme Disease, stroke, Skull fracture, head or neck tumor, and Multiple sclerosis.
Preferred Table
| Diseases | Clinical manifestations | Gold standard of diagnosis | Additional findings | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examination | ||||||||
| Weakness or total paralysis on one side of the face | Difficulty making facial expressions in one side, such as closing eye, smiling and whistling | Salivation | Impaired Facial nerve reflexes | Unintended eye closure with an effort to smile |
| ||||
| Bell’s palsy | ++ | ++ | ++ | ++ | ++ | ++ | Exclusion of other causes of facial nerve palsy |
| |
| Ramsay-Hunt Syndrome | ++ | ++ | ++ | ++ | ++ | ++ |
|
Ramsay Hunt syndrome is caused by the Varicella virus (Herpes zoster) that also causes chickenpox and shingles | |
| Lyme Disease | -/+ | -/+ | -/+ | -/+ | -/+ | -/+ |
| ||
| Stroke | -/+ | -/+ | -/+ | -/+ | -/+ | -/+ | MRI | Sudden unilateral motor and sensory deficit in a patient with a history of atherosclerotic risk factors (diabetes, hypertension, smoking) or atrial fibrillation. | |
| Skull fracture | -/+ | -/+ | -/+ | -/+ | -/+ | -/+ | MRI | History of head injury | |
| Head or neck tumor | -/+ | -/+ | -/+ | -/+ | -/+ | -/+ | MRI |
| |
| Multiple sclerosis | Rare | -/+ | Rare | -/+ | -/+ | Rare | MRI |
| |
References
References
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]