i
Report an error   
Advanced Search


Bilateral Facial Nerve (Bell's) Palsy in a 24-Year-Old Woman: A Case Report.

Author

Camille Q. Tolentino,
Emmanuel Tadeus S.  Cruz

Related Institution

Department of Otolaryngology Head and Neck Surgery - Manila Central University – Filemon D. Tanchoco Medical Foundation Hospital

Department of Otolaryngology Head and Neck Surgery - Manila Central University – Filemon D. Tanchoco Medical Foundation Hospital

Publication Information

Publication Type
Journal
Publication Sub Type
Case report
Title
Philippine Journal of Otolaryngology Head and Neck Surgery
Frequency
Semi-Annual
Publication Date
January-June 2020
Volume
35
Issue
1
Page(s)
60-62

Abstract

OBJECTIVE: To report a case of acute bilateral facial nerve palsy in a 24-year-old woman and to present the differential diagnoses, pathophysiology, management and prognosis.


METHODS:


Design: Case study


Setting: Tertiary Private Hospital


Patient: One (1)


RESULT: A 24-year-old woman with fever, joint pains, cough, chest pain, difficulty ambulating and progressive facial muscle weakness was diagnosed with rheumatic fever. Bilateral facial nerve paralysis was noted, and Electromyography-Nerve Conduction Velocity (EMG-NCV) testing with special facial nerve study revealed abnormal facial nerve and blink reflex studies while EMG-NCV of the upper and lower limbs were normal. Audiometry and MRI of the brain and facial nerve were normal while Schirmer's Test showed decreased tearing in both eyes. The rheumatic fever resolved within 5 days of antibiotics, while Prednisone and physiotherapy resulted in improvement of facial paralysis from House Brackmann V to House Brackmann II-III over a period of 6 months.


CONCLUSION: Idiopathic facial paralysis or Bell's Palsy is the most common cause of acute unilateral facial paralysis while bilateral facial nerve paralysis is a rare condition. Patients with facial palsy should undergo appropriate diagnostics to determine the underlying condition and to facilitate prompt management.

References

1. Rowlands, S , Hooper, R , Hughes, R , Burney, P . "The epidemiology and treatment of Bell’s palsy inthe UK" Eur J Neurol 9(1): 63-7, January 2002. Retrieved from: http://DOI: 10.1046/j.1468-1331.2002.00343.x
2. Adel, B , Kawthar, S , Amine, D , Souha, BY , Abdellatif, B . "Idiopathic Facial Paralysis (Bell’s palsy)" Int. JDent. Sci Research 2(5A): 1-4, 2014. Retrieved from: http://DOI:10.12691/ijdsr-2-5A-1
3. Green, JD Jr , Shelton, C , Brackman, DE . "Iatrogenic facial nerve injury during otologic surgery" Laryngoscope 104(8 pt 1): 922-926, August 1994. Retrieved from: http://DOI: 10.1288/00005537-199408000-00002
4. Teller, DC , Murphy, TP . "Bilateral facial paralysis: a case presentation and literature review" JOtolaryngol 21(1): 44-7, February 1992
5. Pothiawala, S , Lateef, F . "Bilateral facial nerve palsy: a diagnostic dilemma" Case Rep Emerg Med 2012, 458371, 2012. Retrieved from: http://DOI: 10.1155/2012/458371
6. Sutherland, S . "The anatomy and physiology of nerve injury" Muscle Nerve 13(9): 771-84, September 1990. Retrieved from: http://DOI: 10.1002/mus.880130903
7. Sunderland, S . In Fisch USome anatomical and pathophysiological data relevant to facial nerve injury andrepair. In Fisch U, editor. Facial Nerve Surgery. Birmingham: AL: Aesculapius Publishing, 1977. 47-61.
8. Adour, KK , Byl, FM , Hilsinger, RL Jr , Kahn, ZM , Sheldon, MI . "The true nature of Bell’s palsy:analysis of 1000 consecutive patients" Laryngoscope 88(5): 787-801, May 1978. Retrieved from: http://DOI:10.1002/lary.1978.88.5.787
9. Fisch, U . "Prognostic value of electrical tests in acute facial paralysis" Am J Otol 5, 494-8, October 1984
10. Grogan, PM , Gronseth, GS . "Practice parameter: Steroids, acyclovir, and surgery for Bell’s palsy(an evidence-based review): Report of the Quality Standards Subcommittee of the AmericanAcademy of Neurology" Neurology 56(7): 830–6, April 2001. Retrieved from: http://DOI: 10.1212/wnl.56.7.830
11. Greenberg, MR , Urquhart, MC , Eygnor, JK , Worrilow, CC , Gessel, NC , Porter, BG , Miller, AC . "I can’tMove My Face! A Case of Bilateral Facial Palsy" J Am Osteopath Assoc 113(10): 788-790, October 2013. Retrieved from: http://DOI: https://doi.org/10.7556/jaoa.2013.048
12. Sullivan, FM , Swan, IR , Donnan, PT , Morrison, JM , Smith, BH , McKinstry, B . "Early treatmentwith prednisolone or acyclovir in Bell’s palsy" N Engl J Med 357(16): 1598–607, October 2007. Retrieved from: http://DOI:10.1056/NEJMoa072006
13. Carapetis, JR , McDonald, M , Wilson, NJ . "Acute rheumatic fever" Lancet 366(9480): 155-68, July 2005. Retrieved from: http://DOI: 10.1016/S0140-6736(05)66874-2

Physical Location

LocationLocation CodeAvailable FormatAvailability
Philippine Society of Otolaryngology-Head and Neck Surgery Fulltext pdf (Download)
Philippine Society of Otolaryngology-Head and Neck Surgery Fulltext External Link (View)

 
Loading…
©2021 HERDIN PLUS. All rights reserved.