{"id":5759,"date":"2021-12-09T17:41:56","date_gmt":"2021-12-09T17:41:56","guid":{"rendered":"https:\/\/enorcerna.com\/wiki\/neurology\/the-5-differences-between-central-and-peripheral-facial-palsy-explained\/"},"modified":"2021-12-09T17:41:56","modified_gmt":"2021-12-09T17:41:56","slug":"the-5-differences-between-central-and-peripheral-facial-palsy-explained","status":"publish","type":"post","link":"https:\/\/enorcerna.com\/wiki\/neurology\/the-5-differences-between-central-and-peripheral-facial-palsy-explained\/","title":{"rendered":"The 5 differences between central and peripheral facial palsy (explained)"},"content":{"rendered":"
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The movement of any muscle in the body is controlled by the brain<\/strong>, which uses the telecommunications network that constitutes the nervous system as a tool to transmit motor commands. And of all the nerves that make up the nervous system, there are some special ones that have the peculiarity that they are born from the spinal cord, but rather come directly from the brain.<\/p>\n

We are talking about the cranial nerves, a set of 12 pairs of nerves that communicate with peripheral areas (originating from holes at the base of the skull that allow the nerves to reach different regions of the head) without the need to first pass through the spinal cord. . All of them are essential, but in today's article we are interested in par 7: the facial nerve.<\/p>\n

The facial nerve is a very important efferent nerve that transmits electrical signals to allow voluntary muscle movements of the face. Facial expressions, smiling, frowning, opening the mouth, grimacing ... Everything that has to do with the development of movements in the face is possible thanks to this nerve.<\/p>\n

So it should come as no surprise that problems in this facial nerve (or in its control by the central nervous system) lead to a more or less severe inability to move the muscles of the face<\/strong>. And it is at that time that the person can develop facial paralysis, which can be central or peripheral. And in today's article and from the hand of the most prestigious scientific publications, we will see the neurological differences between both manifestations of the pathology. Let's go there.<\/p>\n

What is central facial paralysis? And the peripheral?<\/h2>\n

Before analyzing the differences between both pathologies in the form of key points, it is important that we put ourselves in context and understand, individually, what is central facial paralysis and what is peripheral facial paralysis. In this way, both their similarities and their differences will begin to become much clearer.<\/p>\n

Central facial paralysis: what is it?<\/h3>\n

Central facial paralysis is the partial loss of movement of the voluntary muscles of the lower face due to a brain injury<\/strong>. As it is the consequence of damage to the brain (of the central nervous system), it receives this name that characterizes it. In other words, there is no injury at the level of the facial nerve (peripheral nervous system), but there is at the level of the central nervous system.<\/p>\n

In this sense, central facial paralysis will affect only the lower half of the face, so there will be no problems in muscle movements in the upper areas of the face. Thus, the person can raise their eyebrows or close their eyes. On a more technical level, in central facial paralysis the function of the frontal muscles is preserved.<\/p>\n

The causes of its appearance range from the consequences of a cerebral infarction to the development of tumors, passing through malformations in the vascular system of the brain. But be that as it may, the important thing is that arises when there is damage to the nerve fibers that connect the cerebral cortex with the facial nerve<\/strong>, which, as we have already seen, transmits the nervous commands to the facial muscles.<\/p>\n

That is, despite the fact that the facial nerve is in good condition, the connection with the cerebral cortex is damaged. This causes problems in the muscles on the opposite side of the face where the injury has occurred, affecting the movement of the lower part of the face (there is paralysis in the muscles of the mouth and cheeks), but without, as we have said, negative consequences on a visual level. But beyond this, the severity, management and necessary treatment is very different for each case and it is the neurologist who has to assess the situation.<\/p>\n

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Peripheral facial paralysis: what is it?<\/h3>\n

Peripheral facial paralysis is the complete loss of voluntary muscles on one side of the face due to an injury to the facial nerve.<\/strong>. It is known as Bell's palsy or idiopathic palsy and, in this case, there is no damage at the level of the brain (central nervous system), but directly in the cranial nerve (peripheral nervous system) that transmits motor signals to the muscles of the lc ara.<\/p>\n

It is the most common form of paralysis and most of the time it is due to a viral infectious process caused by catarrhal viruses or by the Herpes Zoster virus, although it can also arise from diseases that affect the facial nerve in a secondary way (such as disease of Lyme or sarcoidosis), development of tumors that damage the facial nerve (such as those that develop in the middle ear) or, in many cases, for unknown cause.<\/p>\n

And although there are serious cases that present with complete paralysis that leaves sequelae for life, many times it arises suddenly but with temporary paralysis, with the patient achieving a complete recovery in a period of, at most, six months. With conservative treatment, peripheral facial palsy has a good prognosis<\/strong>.<\/p>\n

In this case, as we have said, the loss of muscle movement occurs in an entire hemisphere of the face (although its manifestations may be mild), so in this case there will also be paralysis in the lower part of the face, with the inability to raise eyebrows or close eyes. Symptoms are varied and include muscle flaccidity, excessive tear production, loss of sense of taste, jaw pain, severe stabbing headache, increased sensitivity to sound, drooling, pain behind the ear, etc. But even so, with conservative treatment, the prognosis is generally good. Let's not forget that in this case there has been no brain damage.<\/p>\n

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How are central facial palsy and peripheral facial palsy different?<\/h2>\n

After carefully analyzing the clinical and neurological bases of both varieties of facial paralysis, surely their differences (and similarities) have become more than clear. Even so, as we know that everything related to Neurology can be confusing, to facilitate its understanding and synthesize the information visually, we have prepared the following selection of the main differences between central and peripheral facial palsy in the form of key points. Let's go there.<\/p>\n

1. Central facial paralysis is due to damage to the brain; the peripheral, on the facial nerve<\/h3>\n

The most important difference on a neurological level. And it is that as you can guess from its name, central facial paralysis arises from a lesion at the level of the brain (central nervous system), while peripheral facial paralysis appears as a consequence of damage to the facial nerve itself (peripheral nervous system) .<\/p>\n

Thus, while the central one arises after damage to the fibers that connect the cerebral cortex with the facial nerve, the peripheral arises after direct damage to this facial nerve<\/strong>, which, being the 7th pair of the cranial nerves, transmits the nerve impulses to control the muscular movement of the face.<\/p>\n

2. The main cause of central facial palsy is a stroke; peripheral, a viral infection<\/h3>\n

In relation to the previous point, it is important to understand the differences when it comes to causes. And here we have to emphasize that, in general, the causes behind central facial paralysis are more serious<\/strong>. In fact, although there are other triggers such as malformations in the cerebral vascular system or the development of tumors in the central nervous system, the main cause behind central palsy is a stroke.<\/p>\n

In fact, one of the main symptoms of a cerebral infarction is the development of this central facial paralysis with specific symptoms that we will comment on now. On the other hand, if the symptoms are consistent with peripheral facial paralysis, the patient may be calmer. And although there are more serious causes such as Lyme disease or the development of tumors, the most common cause is a viral infection by catarrhal virus or, in some cases, Herpes Zoster. Hence also that the prognosis, as we shall see, is generally better.<\/p>\n

3. In peripheral facial paralysis, loss of mobility occurs throughout an entire hemisphere<\/h3>\n

One of the most important differences is that while in peripheral facial paralysis, this loss of mobility (or reduced sensitivity) occurs in an entire hemisphere of the face, both in the upper and lower facial areas, central facial palsy does not occur in an entire hemisphere, but only in the lower region of one side of the face<\/strong>. This is, at the level of symptoms, one of the key differences for diagnosis.<\/p>\n

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4. In the central facial paralysis eyes can be closed; in the peripheral, no<\/h3>\n

In relation to the previous point, in peripheral facial paralysis, as there is a loss of mobility on the entire side of the face, the person also loses control of the movement of the muscles in the upper area<\/strong>. In other words, you cannot blink or raise your eyebrows. Hence, there are clear symptoms such as excessive tear production, as you cannot close one of the two eyes.<\/p>\n

In central facial paralysis, on the other hand, things are different. Despite what may appear to be its most serious cause, there is no loss of mobility in the upper face. The function of the upper facial muscles is preserved, so although there is paralysis of the muscles of the mouth and cheeks, the person can still blink and raise the eyebrows.<\/p>\n

5. Peripheral facial palsy usually has a better prognosis than central facial palsy.<\/h3>\n

In relation to the causes, the prognosis of peripheral facial paralysis is usually better. And it is that since there is no brain damage and generally appearing as a result of a reversible viral infection, the patient, although there is always a risk of sequelae, usually achieve a full recovery within a maximum period of six months<\/strong>. With central facial paralysis, things are different, since there has been damage to the central nervous system (usually due to a cerebral infarction), so the prognosis, although it depends a lot on the case, is somewhat more complicated than in the peripheral.<\/p>\n<\/div>\n\n\n

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