Droopy Face: Bell's Palsy or Stroke? (Time is Brain)

Facial drooping complaints are often encountered in clinical practice. Not a few cases are serious or even fatal because it turns out to be caused by a stroke or tumor. Based on prevalence, causes of facial drooping include Bell's palsy, stroke, cerebellopontine angle tumor, Ramsay Hunt syndrome, Lyme disease, Guillain-Barré syndrome, Multiple sclerosis and others. Bell's palsy accounts for about 60-70% of cases, stroke about 20-30%, and cerebellopontine angle tumors about 5-10%. The treatment regimens of these diseases are very different, so correct diagnosis is very important.

Bell's palsy is an idiopathic facial nerve paralysis that is generally temporary. One theory of the cause is herpes simplex virus (HSV) infection, where reactivation of this virus in the geniculate ganglion causes inflammation and swelling of the facial nerve. Additionally, other theories include autoimmune disorders and microvascular dysfunction. The main effective treatment is steroid administration, especially if given within 72 hours of the first symptoms appearing. EMG-NCV examination can help in diagnosis and determine prognosis.

Tumors in the cerebellopontine angle area, such as acoustic neuroma, can also cause facial drooping, similar to Bell's palsy. However, this condition is often accompanied by additional symptoms such as dizziness, impaired coordination, balance and headaches. These symptoms are often not realized or ignored by patients, but can be detected through a neurological physical examination. To confirm the diagnosis, supporting examinations such as a CT scan of the head or MRI are needed.

Stroke is another serious cause of facial drooping. Accompanying symptoms such as weakness on one side of the body, speech problems, vision problems, dizziness, problems with coordination, balance and headaches also often appear and are sudden in nature. In brain stem stroke, facial drooping can be very similar to Bell's palsy. Therefore, it is important to be aware of uncontrolled stroke risk factors. Immediate neurological examination is essential to differentiate stroke from Bell's palsy and provide appropriate intervention, such as intravenous thrombolysis within the 4.5-hour golden period to prevent complications. Don't delay a neurological/nervous examination if you experience complaints of facial drooping. Quick treatment can avoid serious complications and permanent disability. Complaints of facial drooping should be a reason to immediately go to the hospital, where neurological and supporting examinations can be performed for a proper diagnosis.

RS Hermina Tangkubanprahu memiliki layanan stroke kode dengan tim terlatih dan manajemen terarah. Penanganan yang cepat dan tepat dapat mencegah kecacatan permanen akibat stroke. Ingat, waktu adalah otak. Setiap detik pada stroke sangat berharga karena jutaan neuron dapat mati. Patofisiologi stroke, seperti daerah penumbra dan edema serebral, berkontribusi terhadap gejala penyerta seperti kelemahan anggota tubuh, gangguan kesadaran, dan komplikasi lain seperti infeksi paru, gagal napas, dan serangan jantung. Jangan ragu untuk segera pergi ke rumah sakit jika Anda memiliki keluhan wajah terkulai (RIR).