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Refractory Facial Paralysis: A Case Report.

Yu-Wei Hsu1, Jiunn-Tay Lee1, Yi-Shu Liao2

  • 1Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.

Acta Neurologica Taiwanica
|December 19, 2017
PubMed
Summary
This summary is machine-generated.

Salivary gland cancer can mimic Bell's palsy, causing persistent facial paralysis. Early brain imaging is crucial for diagnosing rare causes of facial nerve paralysis.

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Area of Science:

  • Neurology
  • Oncology
  • Otorhinolaryngology

Background:

  • Bell's palsy is a common cause of acute facial paralysis.
  • Persistent or atypical facial paralysis warrants further investigation beyond Bell's palsy.

Observation:

  • A 75-year-old woman presented with persistent right facial paralysis initially diagnosed as Bell's palsy.
  • Magnetic resonance imaging (MRI) revealed mastoid and jugular bulb involvement.
  • Pathological analysis confirmed adenoid cystic carcinoma of the salivary gland.

Findings:

  • Adenoid cystic carcinoma can present insidiously, mimicking benign conditions like Bell's palsy.
  • Advanced imaging is essential for identifying the extent of malignancy.
  • Malignancy required chemoradiotherapy, but resulted in permanent facial palsy.

Implications:

  • Salivary gland malignancy should be considered in the differential diagnosis of persistent facial nerve paralysis.
  • Contrast-enhanced brain MRI is vital for accurate diagnosis.
  • Timely diagnosis and treatment are critical for managing salivary gland malignancies affecting cranial nerves.