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Case of bilateral Bell's palsy
Yumi Otaka1, Yukinori Harada1, Taro Shimizu2
1DepartDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University, Shimotsuga-gun, Japan.
BMJ Case Reports
|June 10, 2022
Summary
Bell's palsy is the most likely cause of isolated bilateral facial palsy in non-endemic areas. Prompt steroid therapy is recommended for patients suspected of having Bell's palsy.
Area of Science:
- Neurology
- Ophthalmology
Background:
- Bilateral facial palsy is a rare condition.
- Distinguishing between various causes like Bell's palsy, viral infections, Guillain-Barré syndrome, and sarcoidosis is crucial for effective treatment.
Observation:
- A 70-year-old male presented with a 4-day history of bilateral frontal headache, facial heaviness, and inability to close his eyes, wrinkle his forehead, or move the corners of his mouth.
Findings:
- Clinical presentation and diagnostic workup strongly suggested Bell's palsy over other potential causes.
- The patient showed significant symptom improvement following prompt oral administration of prednisolone, valacyclovir, and mecobalamin.
Implications:
- Bell's palsy should be considered the primary diagnosis for isolated bilateral facial palsy in regions where Lyme disease is not prevalent.
- Immediate initiation of steroid therapy is advised for patients presenting with bilateral facial paralysis and suspected Bell's palsy to improve outcomes.
