DIAGNOSIS CHECKLIST
for Facial paralysis

Why: to determine if acute or chronic.

Why: e.g. if sudden onset must consider Bell's palsy, diabetic neuropathy and stroke as cause. If gradual onset must consider acoustic neuroma, advancing petrositis, brain tumor or brain abscess.

Why: e.g. if still able to furrow the brow and wrinkle the forehead, the cause of the facial paralysis is most likely due to a brain stroke or brain tumor.

Why: e.g. if both sides of the face are affected, this may suggest Guillain-Barre syndrome, bilateral parotid disease (such as sarcoidosis), primary muscle disease (such as Dystrophia myotonica), motor neurone disease and myasthenia gravis.

Why: may suggest fracture of petrous temporal bone causing a facial nerve palsy.

Why: may suggest Lyme disease.

Why: e.g. high blood pressure, high cholesterol, diabetes, smoking, atrial fibrillation, family history of early stroke.

Why: e.g. Diabetes, strokes, multiple sclerosis, sarcoidosis, middle ear infection.

Why: e.g. oral contraceptive pill may increase the risk of stroke.

Why: If paralysis or weakness was of sudden onset consider stroke, extradural or subdural hematoma (blood clot). If weakness of body is on the opposite side to the facial paralysis consider brain stem thrombosis (clot) or hemorrhage (bleed). If the weakness of one side of the body is gradual in onset consider a brain tumor, brain abscess or brain degenerative disease.

Why: should consider acoustic neuroma, petrositis, mastoiditis, herpes zoster and cholesteatoma.

Why: e.g. marked weakness on one side of the face, mouth sags, drooling from the affected side of mouth, loss of taste on front of tongue, eye may water, pain behind the ear.