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Quick Review #265 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental #facialparalysis #bellspalsy

- 2.6.25

Facial paralysis is classified based on location, onset, progression, and cause.

1. ​ Central vs. Peripheral Paralysis

• ​ Central (UMN - brain lesion): Forehead is spared, contralateral weakness; seen in stroke, multiple sclerosis (MS), brain tumors.
• ​ Peripheral (LMN - facial nerve lesion): Entire face affected, ipsilateral weakness; seen in Bell’s palsy, Ramsay Hunt syndrome, Lyme disease, trauma, parotid tumors (De Diego-Sastre et al., 2016).

1. ​ Acute vs. Chronic Paralysis

• ​ Acute (<72 hrs onset): Bell’s palsy, stroke, Ramsay Hunt, trauma; sudden weakness, pain, hyperacusis, taste loss.
• ​ Chronic (>3 months): Parotid tumors, neurosarcoidosis, Melkersson-Rosenthal syndrome; gradual worsening, mass effect (Fattah et al., 2014).

1. ​ Congenital vs. Acquired Paralysis

• ​ Congenital: Moebius syndrome, congenital facial nerve palsy, hemifacial microsomia; present at birth, craniofacial defects possible.
• ​ Acquired: Bell’s palsy, stroke, tumors, infections; develops later due to underlying pathology (Eviston et al., 2015).

1. ​ Complete vs. Incomplete Paralysis

• ​ Complete: Total loss of voluntary movement, inability to close the eye, severe Bell’s palsy, trauma, full nerve damage.
• ​ Incomplete (paresis): Partial movement remains, seen in mild Bell’s palsy, partial nerve compression.

1. ​ Unilateral vs. Bilateral Paralysis

• ​ Unilateral: Bell’s palsy, stroke, Ramsay Hunt, trauma, parotid tumors; one-sided weakness.
• ​ Bilateral: Guillain-Barré syndrome (GBS), Lyme disease, neurosarcoidosis, Moebius syndrome, Melkersson-Rosenthal syndrome; symmetrical facial weakness, systemic symptoms.

1. ​ Recurrent vs. Progressive Paralysis

• ​ Recurrent: Melkersson-Rosenthal syndrome, MS, idiopathic facial palsy; episodes of weakness, recovery in between.
• ​ Progressive: Tumors, chronic infections, neurodegenerative diseases; gradual worsening, systemic involvement.

References:

1. ​ Shaina. (2024, July 9). Bell’s palsy: What is it and how to treat it? Gulf Physio.
2. ​ De Diego-Sastre, J. I., Prim-Espada, M. P., & Fernández-García, F. (2016). The epidemiology of Bell’s palsy. Revue de Laryngologie - Otologie - Rhinologie, 137(4-5), 173-176.
3. ​ Eviston, T. J., Croxson, G. R., Kennedy, P. G. E., Hadlock, T., & Krishnan, A. V. (2015). Bell’s palsy: Aetiology, clinical features, and multidisciplinary care. Journal of Neurology, Neurosurgery & Psychiatry, 86(12), 1356-1361
4. ​ ChatGPT.2025

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