Bilateral Facial Nerve (Bell’s) Palsy in a 24-Year-Old Woman: A Case Report

  • Camille Q. Tolentino Department of Otolaryngology Head and Neck Surgery Manila Central University – Filemon D. Tanchoco Medical Foundation Hospital https://orcid.org/0000-0001-8866-0764
  • Emmanuel Tadeus S. Cruz Department of Otolaryngology Head and Neck Surgery Manila Central University – Filemon D. Tanchoco Medical Foundation Hospital
Keywords: facial paralysis, idiopathic, Bell’s palsy

Abstract

ABSTRACT

Objective: To report a case of acute bilateral facial nerve palsy in a 24-year-old woman and to present the differential diagnoses, pathophysiology, management and prognosis

Methods:

Design: Case study

Setting: Tertiary Private Hospital

Patient: One (1)

Result: A 24-year-old woman with fever, joint pains, cough, chest pain, difficulty ambulating and progressive facial muscle weakness was diagnosed with rheumatic fever. Bilateral facial nerve paralysis was noted, and Electromyography-Nerve Conduction Velocity (EMG-NCV) testing with special facial nerve study revealed abnormal facial nerve and blink reflex studies while EMG-NCV of the upper and lower limbs were normal. Audiometry and MRI of the brain and facial nerve were normal while Schirmer’s Test showed decreased tearing in both eyes. The rheumatic fever resolved within 5 days of antibiotics, while Prednisone and physiotherapy resulted in improvement of facial paralysis from House Brackmann V to House Brackmann II-III over a period of 6 months.

Conclusion: Idiopathic facial paralysis or Bell’s Palsy is the most common cause of acute unilateral facial paralysis while bilateral facial nerve paralysis is a rare condition. Patients with facial palsy should undergo appropriate diagnostics to determine the underlying condition and to facilitate prompt management.

Keywords: facial paralysis, idiopathic; Bell’s palsy

Downloads

Download data is not yet available.
Published
2020-05-17
How to Cite
1.
Tolentino C, Cruz ET. Bilateral Facial Nerve (Bell’s) Palsy in a 24-Year-Old Woman: A Case Report. Philipp J Otolaryngol Head Neck Surg [Internet]. 2020May17 [cited 2020Nov.24];35(1):60-2. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/1285