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Facial Weakness

Facial weakness

Facial weakness is the problem when the face appears “twisted”. Due to a weakness in facial muscle, there could also be problems like not being able to smile, close the eye, and drooling of food or saliva from one side of the mouth. Bell’s Palsy causes facial weakness.

Understand the anatomy of facial muscle control

There are mainly two essential muscles of the face, namely, the right and the left. The right facial nerve controls the right side of the face, and the left facial nerve controls the left side of the face. The nerves come out from the middle of the brainstem and carry motor fibres. These fibres supply muscles to all part of the face that is the upper face or lower face. Facial weakness happens when this nerve gets affected 

Bell’s Palsy

Bell’s Palsy causes facial weakness, it could happen anytime, even during the night when you must be sleeping, and in the morning, you might find your face appearance twisted. Weakness could be in the mouth, eyes or forehead.

Clinical features include – 

  1. Difficulty in closing eyes
  2. Weakness in smiling
  3. Difficulty in raising eyebrows or frowning.

How to figure out whether it is an acute stroke or Bell’s Palsy?

The doctor follows specific steps such as –

Verbal communication – doctor talks to the patient about when he started feeling weakness. It is crucial to know the onset time because stroke picks up the severity within seconds while bell Palsy takes time. Family members or friends could help in estimating when the person was seen with no facial disturbance.

Neurological exam – take the neurological exam of their face, eyes and forehead. It will help in accumulating precise details about the problem. Brainstem strokes and Bell’s Palsy can have a similar way of travelling and causing the facial difference.

Signs and symptoms – look for the specific symptoms such as facial numbness, double vision, slurred speech, weakness or numbness in arms or legs, difficulty in swallowing or vertigo. 

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