Recurrent peripheral facial palsy
Differentiate supranuclear facial palsy from peripheral (nuclear) facial palsy. Supranuclear palsy involves predominantly the lower part of the face. Emotional responses may be intact (e.g., the patient may not be able to show you his teeth but will smile in response to a joke). Peripheral, or nuclear facial, palsy affects all ipsilateral muscles of facial expression, resulting in paralysis of the entire ipsilateral side. The mouth is pulled at an angle to the normal side and may droop on the affected side, facial creases are effaced, and the eyelid may not close.
