Bilateral facial nerve palsy: a case study and literature review

Facial diplegia is a rare clinical finding and can be the presenting complaint in a wide spectrum of diseases. This paper describes a case of bilateral facial palsy occurring in a diabetic patient. Electroneurographic studies demonstrated severe acute denervation of both facial nerves and a widespread polyneuropathy. A gallium scan revealed hilar and paratracheal lymphadenopathy. Heerfordt's syndrome was suspected; however, histological confirmation of sarcoidosis has not been obtained. The patient was treated with high dose steroid therapy and has made an almost complete recovery after six months. A review of the literature is discussed with particular reference to the differential diagnosis in this patient.