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Bilateral facial nerve palsy: four case reports
1ENT Department, Ciutat Sanitària i Universitària de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Summary
Bilateral facial palsy, or weakness on both sides of the face, is rare. This study presents four cases, highlighting diverse causes and treatment outcomes for this uncommon neurological condition.
Area of Science:
- Neurology
- Infectious Diseases
- Hematology
Background:
- Bilateral facial nerve palsy is an uncommon condition with diverse potential causes, including neurological, infectious, neoplastic, and degenerative disorders.
- The seventh cranial nerve (facial nerve) controls facial expressions, taste, and tear/saliva production. Bilateral involvement presents unique diagnostic and therapeutic challenges.
Observation:
- Four cases of bilateral facial diplegia are presented.
- Causes included refractory anemia with excess of blasts (myelodysplastic syndrome), Lyme disease, and tuberculoid leprosy.
- One case of idiopathic bilateral facial palsy (Bell's palsy) was also observed.
Findings:
- Three patients experienced a return to normal facial nerve function after corticosteroid treatment.
- The patient diagnosed with myelodysplastic syndrome showed no improvement and unfortunately died six months post-diagnosis.
Implications:
- This case series underscores the importance of a thorough diagnostic workup for bilateral facial palsy to identify underlying systemic diseases.
- Prompt recognition and treatment of associated conditions may improve outcomes for patients with bilateral facial nerve palsy.
- Further research is needed to elucidate the specific mechanisms and optimize treatment strategies for various etiologies of bilateral facial palsy.