Bell's palsy at high altitude -- an unsuspected finding

Area of Science:

• Neurology
• Endocrinology
• Radiology

Background:

• Bell's palsy is a common idiopathic condition requiring neuroimaging to rule out intracranial pathology.
• Infra-nuclear facial palsy necessitates thorough investigation for underlying causes.

Purpose of the Study:

• To report a unique case of Bell's palsy associated with intracranial calcifications.
• To identify the underlying etiology of these findings in a military population.

Main Methods:

• A case presentation of a young soldier with Bell's palsy.
• Neuroimaging was performed to evaluate intracranial structures.
• Metabolic workup was conducted to determine the cause of calcifications.

Main Results:

• Neuroimaging revealed unexpected multiple intracranial calcifications.
• The patient was diagnosed with vitamin D deficiency and secondary hyperparathyroidism.
• Lack of sun exposure at high altitude was identified as the contributing factor.

Conclusions:

• Vitamin D deficiency and secondary hyperparathyroidism can manifest with intracranial calcifications.
• Healthcare providers for soldiers in high-altitude regions must be vigilant for vitamin D deficiency.
• This association is uncommon and warrants clinical awareness.