Could this be a stroke?

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Submitted by Dr T on August 2, 2011 – 7:51am

Question: 
My aunt is 62 years old. For about a month her mouth on the right side has been drooping. When this happened she also had some issue with the eye. I think she was not able to see clearly. I am wondering is this an indication of a stroke? Is the mouth droop permanent or is there something to be done about it (like some kind of a therapy)? She did not go to a doctor. Thank you for your help.

In the absence of other symptoms, it is more likely that she may have a condition called Bell’s palsy, caused by damage to the facial nerve that controls the muscles on the side of your face.

Bell’s palsy is not the result of a stroke or a transient ischemic attack (TIA). However, sudden weakness that occurs on one side of the face should be checked by a doctor to rule out more serious causes: If  sudden paralysis of the face occurs, a stroke needs to be excluded ASAP by an expert.

The most common cause of Bell’s palsy appears to be the herpes simplex virus, which also causes cold sores and genital herpes. Several other conditions can cause facial paralysis, such as a brain tumor, stroke or Lyme disease. However, if no specific cause can be identified, the condition is known as Bell’s palsy.

Symptoms include :

  • Rapid onset of mild weakness to total paralysis on one side of your face,  making it difficult to smile or close your eye on the affected side
  • Facial droop
  • Pain on the affected side
  • Headache
  • A decrease in taste

Other conditions — such as a stroke, infections, Lyme disease and tumors — also may cause facial muscle weakness, mimicking Bell’s palsy. If your diagnosis is still in question, your doctor may recommend other tests, including:

  • Electromyography (EMG). An EMG measures the electrical activity of a muscle in response to stimulation of the nerve.
  • Imaging scans like a MRI and/or CT may be needed to exclude  other possible sources of injury to the facial nerve.

Treatment:

Most people with Bell’s palsy recover fully with or without treatment. Corticosteroids and antiviral drugs have been used with mixed results. Physical therapy may help.In rare cases surgery may be needed.

You can estimate the risk of stroke here:
https://www.cardiachealth.org/app/risk-assessment.php

Hope this helps,
Dr T

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