Bilateral facial nerve palsies: Groote Schuur Hospital experience

Bilateral facial nerve palsies are rare. This article details the Cape Town experience of 24 patients with this condition seen over the past 20 years and highlights the three main groups in which these bilateral facial nerve palsies occurred. These are Bell's palsy, fracture of the temporal bones and sclerosteosis. A variety of other rare causes was also found. Bell's palsy remains a diagnosis of exclusion though there has been some evidence to suggest implication of the Herpes simplex virus. The mechanism whereby temporal bone fractures cause bilateral facial nerve palsies is discussed. The clinical presentation and management of sclerosteosis is also discussed.