person covering face with hand

How To Differentiate Bell’s Palsy From Lyme-Related Facial Palsy

Lyme disease is often called “the great imitator” because its symptoms can be easily mistaken for those of other conditions. There are three stages of a Lyme infection, all of which present with various ailments comparable to well-known disorders. For example, during the first stage of the disease, people experience symptoms that resemble the flu. 

As Lyme advances to Stage 2, symptoms that resemble heart problems can be present. Late-stage Lyme disease, or Stage 3 of the infection, can present similarly to arthritis, vertigo, cognitive disorders, and chronic fatigue syndrome. Because of its ability to appear as something else entirely, it isn’t easy to diagnose Lyme. 

One other condition that Lyme disease can mimic is Bell’s palsy. But what is Bell’s palsy, and what symptoms occur in Lyme disease that present in a similar manner? Read on to learn how to differentiate Bell’s palsy from Lyme-related facial palsy.

What is Bell’s palsy? 

Bell’s palsy develops as facial muscle weakness or paralysis of the face. It comes on unexpectedly and typically worsens over 48 hours. Anyone can suffer from Bell’s palsy at any age, and it’s thought to be caused by damage to the facial nerve.

Along with facial weakness and paralysis, pain may be present. Other symptoms may develop, such as: 

  • Disordered movement of the facial muscles that result in squinting, blinking, or closing the eyelids 
  • Headache 
  • Tearing from the eyes 
  • Drooling 
  • Loss of taste 
  • Hypersensitivity to sound 
  • Inability to close an eye on the side that is affected

The damage that occurs to the facial nerve isn’t usually permanent, and the function of facial muscles is restored within two weeks to six months after Bell’s palsy begins. While medical researchers aren’t clear on the underlying cause of the nerve damage, people with diabetes and those who are pregnant are the most likely to experience the phenomena.

Other possible associations include: 

  • High blood pressure
  • Injuries to the nerve
  • Inflammation caused by an immune response 
  • Multiple sclerosis 
  • Sarcoidosis 
  • Myasthenia gravis 
  • Toxin buildup 
black and red tick
Image by Erik Karits on Unsplash: Does Lyme disease cause facial paralysis? 

What is Lyme facial palsy? 

The facial paralysis developed in Bell’s palsy can also happen in people with Lyme disease. This is because the bacteria that causes Lyme disease can damage nerves, including the facial nerve, if it makes its way to the nervous system. That damage then leads to the symptoms of facial paralysis or weakness on one or both sides of the face.  

Can Lyme disease mimic Bell’s palsy? 

Lyme disease can mimic Bell’s palsy because it presents with the same main symptom. However, Lyme disease does not typically present with the other symptoms of Bell’s palsy. Interestingly, Lyme may actually be an underlying cause of Bell’s palsy. It is one of the most common causes of the condition in areas with high tick numbers. 

There are differences between Lyme disease-included Bell’s palsy, facial paralysis caused by Lyme disease, and Bell’s palsy of unknown origin. For example, suppose a person develops Lyme facial paralysis because of a Lyme disease infection. In that case, they will likely present with other symptoms that are not typical of Bell’s palsy, such as: 

  • Fever
  • Chills
  • Neck stiffness
  • Flu-like symptoms 

The same cannot be said for Lyme-induced Bell’s palsy because other symptoms of the infection are unlikely to develop in this case. When Bell’s palsy develops unrelated to Lyme disease, these symptoms are not present and the other symptoms of Bell’s palsy are. 

tick on leaf
Image by Erik Karits on Pixabay: Can Lyme disease cause Bell’s palsy? 

How do you rule out Bell’s palsy? 

Lyme disease and Bell’s palsy have completely different diagnostic processes. To diagnose Lyme disease, you must get a blood test to confirm if the bacteria or antibodies created in response to the bacteria are within your bloodstream. If they are, the symptom of facial paralysis is most likely caused by Lyme disease. A Lyme infection could also cause nerve damage that leads to Bell’s palsy. 

Diagnosing Bell’s palsy requires a blood test to rule out Lyme disease and other conditions. In addition, an MRI (magnetic resonance imagery) or CT (computed tomography) scan is needed to see if the nerve is structurally damaged. Another EMG (electromyography) test may also be performed to check the extent of the nerve damage. 

Lyme facial palsy vs. Bell’s palsy: how to tell the difference 

It can be challenging to determine between Lyme facial palsy and Bell’s palsy. However, it’s not impossible, because the symptoms are not always the same. Before getting tests to see what’s going on, pay attention to any additional symptoms you may be experiencing, even if they seem irrelevant. Both Lyme disease and Bell’s palsy present with different symptoms along with facial paralysis. These other symptoms may help you in your investigation to find the underlying cause. 

Facial paralysis caused by Bell’s palsy and Lyme disease isn’t always permanent. If you experience this symptom, seeking prompt treatment is of the utmost importance to restore full facial function. 

Featured image by ROCKETMANN TEAM on Pexels

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