“Half my face has dropped — I look like I’ve had a stroke”

Sudden one-sided facial droop forces the Bell’s-vs-stroke discrimination, and the KEY sign is the FOREHEAD: in a lower-motor-neurone (Bell’s) palsy the forehead is INVOLVED (can’t raise the eyebrow) because the upper face has bilateral cortical innervation, whereas an upper-motor-neurone (stroke) lesion SPARES the forehead — a strong clue but not absolute, since a brainstem stroke can involve the whole face. Forehead involvement with isolated facial weakness and no other neurology (normal limbs, speech, vision), plus supportive features (post-auricular ache, altered taste, recent virus), points to Bell’s — but sudden facial weakness still needs prompt same-day assessment to exclude stroke and examine fully. Treat Bell’s with early corticosteroids (ideally within 72 h) and — crucially and commonly missed — EYE PROTECTION (lubrication, night taping) to prevent exposure keratopathy; consider Ramsay Hunt (vesicles, severe pain → add antivirals), Lyme and other causes, and manage pregnancy with obstetric input (without delaying steroids), checking blood pressure and urine for pre-eclampsia. The examinable hidden agenda is twofold fear — a relative’s stroke and an unspoken fear for the baby; reassure with the forehead-sign reasoning, address the pregnancy fear, give the good prognosis (most recover well), and safety-net stroke/Ramsay-Hunt/eye red flags.