Neurological dilemma: How to distinguish between central and peripheral facial paralysis?

Abstract

Background: Facial nerve palsy is reviewed in this article with the focus on clinical differentiation.

Objective: The clinical and scientific texts have less detailed information about differences or similarities between the forms. It is reflected in many questions that neurologists, resident-physicians and other no-neurology specialists inquire about facial nerve palsy on social media and other forums. The superficial and simplified approach can be easy to grasp, however it does rarely support the real patient case in day-to-day work of given physician. The recent advances in medicine and neurology specifically have added to the knowledge base about facial nerve palsy.

Material and methods: We have reviewed current clinical guidelines, Cochrane database, original articles, textbooks on neurology, guidebooks and monographs published in recent years. Most national and international textbooks, guides and monographs have simplified description of facial nerve neuropathy, including differentiation into central and peripheral forms.

Results: More detailed understanding and application of modern knowledge related to facial nerve neuropathy can prevent clinical diagnostic errors.