Bell's Palsy with Secondary Ear Infection: This is the most likely diagnosis because Bell's palsy can cause pain in the ear due to the involvement of the facial nerve, which runs close to the ear. A secondary ear infection could exacerbate the ear ache.

Ramsay Hunt Syndrome Type 2: This condition is caused by the varicella-zoster virus reactivating in the geniculate ganglion, leading to facial paralysis (similar to Bell's palsy) and ear pain, along with vesicles in the ear.
Otitis Media: An ear infection could cause ear ache, and if the infection spreads or affects the facial nerve, it could lead to symptoms mimicking Bell's palsy.
Temporomandibular Joint (TMJ) Disorder: TMJ disorders can cause ear pain and, in some cases, may be associated with facial weakness or pain that could be mistaken for Bell's palsy.

Stroke or Cerebrovascular Accident (CVA): Although less common, a stroke can present with sudden onset of facial weakness that might be mistaken for Bell's palsy. Ear pain is not a typical symptom but could be present due to other associated conditions.
Lyme Disease: Neurological manifestations of Lyme disease can include facial palsy (similar to Bell's palsy) and, in some cases, ear pain due to meningitis or other complications.
Sarcoidosis: This autoimmune disease can cause facial nerve palsy and might be associated with ear symptoms due to its systemic nature.

Tumors Affecting the Facial Nerve: Rarely, tumors (benign or malignant) affecting the facial nerve can cause symptoms of Bell's palsy along with ear pain due to the tumor's location or effects on surrounding structures.
Multiple Sclerosis: This chronic autoimmune disease can cause a wide range of neurological symptoms, including facial weakness and pain, though it would be an uncommon presentation.
Guillain-Barré Syndrome: An autoimmune disorder that can cause rapid-onset muscle weakness, which might include facial weakness. Ear pain is not a typical symptom but could occur due to associated conditions.