Korean J Geriatr Gerontol.  2025 Apr;26(1):47-49. 10.15656/kjgg.2025.26.1.40.

Clinical Significance of Differentiating Peripheral and Central Facial Palsy in Older Patients

• Chae HM
• Kwon DH

• KMID: 2567826
• DOI: http://doi.org/10.15656/kjgg.2025.26.1.40

Abstract

The diagnosis of facial palsy in older patients is challenging due to age-related changes such as facial asymmetry and wrinkles, along with conditions such as hypertension and diabetes, which increase the risk of primary causes such as stroke that can mimic peripheral palsy. This case report describes the diagnostic difficulties in differentiating between peripheral and central facial palsy in a 78-year-old female with hypertension and diabetes. Although the initial clinical findings suggested peripheral Bell’s palsy, further imaging revealed a pontine infarction, confirming a primary cause. This case emphasizes the importance of comprehensive diagnostic evaluation, including magnetic resonance imaging, in older patients to avoid misdiagnosis and ensure timely treatment, especially in those with vascular risk factors. Appropriate differentiation between peripheral and central facial palsy is crucial to improve patient outcomes.

Keyword

Facial palsy; Older patients; Pontine infarction