How to Differentiate Bell’s Palsy and Stroke

Bell’s Palsy and Stroke both cause facial droop and can often be confused with each other during initial onset. Many paramedics treat Bell’s Palsy as a Stroke when they first attend a patient, but later determine that it is actually Bell’s Palsy. Both conditions are likely to cause alot of agitation and anxiety for the patients.

It is important as a paramedic to understand the difference between Bell’s Palsy and a Stroke.

The following methods can be utilised to differentiate between Bells Palsy and a Stroke:

1. Assess the person’s entire body for signs of weakness, if the person has a weakness to the entire body and not just the face, it is more likely to be Stroke than Bell’s Palsy, which generally only affects the facial nerves.

2. Ask the person to raise both eyebrows. If they can raise both eyebrows, but have a lower facial droop, then it is more likely that they have Bell’s Palsy. In contrast, if they are unable to raise both eyebrows and have a weakness to one entire side of their face, then they are likely to have had a stroke.

Telling the Difference Between Bell’s Palsy and Stroke

A sudden onset of Bell’s Palsy or a Stroke is likely to be very scary for the patient, and regardless of the pathology of the disease both should be considered medical emergencies in the pre-hospital care environment and treated accordingly.