Bilateral facial nerve palsy: challenges in diagnosis

Authors

  • Mayank Yadav Department of ENT, SHKM Govt. Medical College, Nalhar, Nuh, Haryana
  • M. Khalid Farooqui ENT Specialist, Kota, Rajasthan
  • S. M. Naik Department of ENT, SHKM Govt. Medical College, Nalhar, Nuh, Haryana
  • Ruby Naz Department of Microbiology, SHKM Govt. Medical College, Nalhar, Nuh, Haryana, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20171212

Keywords:

Bilateral facial nerve palsy, Bell’s palsy

Abstract

Bilateral facial palsy is a rare condition accounting for less than 2% of all cases of facial nerve palsy. Most of the patients develop bilateral facial nerve palsy secondary to underlying medical condition, which can be neurologic, infectious, traumatic, neoplastic or metabolic disorder. Clinicians should be careful enough to face the diagnostic dilemma and to rule out wide range of differential diagnosis in these cases, some of which can be potentially fatal. Treatment should be initiated according to the diagnosis. We are reporting a case of 26 year old man who presented to our ENT OPD with bilateral facial nerve palsy. The condition could not be attributed to any particular aetiology hence presented a diagnostic dilemma. We endorse the practice of considering wide range of differential diagnosis in all case of bilateral facial nerve palsy. These patients should undergo prompt laboratory and radiological investigations and gruelling evaluation of underlying cause for further specific management.

References

Keane JR. Bilateral seventh nervepalsy: analysis of 43cases and review of the literature. Neurology. 1994;44(7);1198–202.

Teller DC, Murphy TP. Bilateral facial paralysis: a case presentation and literature review. Journal of Otolaryngology. 1992;21(1):44–7.

George MK, Pahor AL. Sarcoidosis: a cause for bilateral facial palsy. Ear Nose Throat J.1991;70:492–3.

May M, Klein SR. Differential diagnosis of facial nerve palsy. Otolaryngologic Clinics of North America. 1991;24(3):613–45.

Serrano P, Hern´andez N, Arroyo JA, de Llobet JM, Domingo P. Bilateral Bell palsy and acute HIV type1infection: report of 2 cases and review. Clinical Infectious Diseases. 2007;44(6):57–61.

McIntosh WE, Brenner JF, Aschen Brenner JE. Bilateral facial paralysis as the sole presenting feature of sarcoidosis: report of a case. J Am Osteopath Assoc. 1987;87:245–7.

George MK, Pahor AL. Sarcoidosis: a cause for bilateral facial palsy. Ear NoseThroat J. 1991;70:492–3.

Kamaratos A, Kokkoris S, Protopsaltis J, Agorgianitis D, Koumpoulis H, Lentzas J, et al. Simultaneous bilateral facial palsy in a diabetic patient. Diabetes Care. 2004;27(2):623–4.

Adour KK, Wingerd J, Doty HE. Prevalence of concurrent diabetes mellitus and idiopathic facial paralysis (Bell’spalsy). Diabetes.1975;24(5):449–51.

Jairath V, Sehrawat M, Jindal N, Jain VK, Aggarwal P. Lyme disease in Haryana, India. Indian J Dermatology Venereology Leprology. 2014;80:320-3.

K.Terada, T.Niizuma, Y.Kosaka, M.Inoue, S.Ogita, and N. Kataoka. Bilateral facial nerve palsy associated with Epstein- Barr virus infection with a review of the literature. Scandinavian Journal of Infectious Diseases. 2004;36(1):75–7.

Coddington CT, Isaacs JD, Siddiqui AQ, Andrews TC. Bilateral facial nerve palsy associated with Epstein- Barr virus infection. Journal of Neurology, Neurosurgery and Psychiatry. 2010;81(10):1155–6.

Jain V, Deshmukh A, Gollomp S. Bilateral Facial Paralysis Case Presentation and Discussion of Differential Diagnosis. J Genintern Med. 2006;21:C7–C10.

Shaikh ZA, Bakshi R, Wasay M, Dai A, Gosy E. Magnetic Resonance imaging findings in bilateral Bell’s palsy. Journal of Neuro-imaging. 2000;10(4):223–5.

Downloads

Published

2017-03-25

Issue

Section

Case Reports