Post-stroke facial palsy: Prevalence, recovery patterns within the first 7 days, risk factors, and effect of hyperacute treatments.

The study was conducted at a single centre, which may limit generalisability to populations with different case-mixes or admission pathways. Recovery analysis started from the first facial palsy assessment, not the time of symptom onset. This 'left truncation' means patients who recovered very quickly before assessment were missed, potentially making recovery rates appear slower than they are. The association between intravenous thrombolysis and better recovery may be confounded by selection bias, as treated patients often had known, early onset times and potentially more transient symptoms. Facial palsy severity was assessed using the NIHSS, which is not as detailed as specialised facial movement scales, potentially affecting the precision of severity grading. The study only looked at the first 7 days, so long-term recovery patterns and outcomes are unknown.

The authors declared no financial support and no potential conflicts of interest.

Do not interpret the association between intravenous thrombolysis and improved facial palsy recovery as proof that the drug treats the palsy directly. The authors note that patients eligible for thrombolysis often had earlier, more transient symptoms that might have resolved anyway, so the benefit may reflect patient selection rather than a specific treatment effect on the facial nerve.