Case of bilateral Bell's palsy. Issue 6 (10th June 2022)

• Record Type: Journal Article
• Authors: Otaka, Yumi; Harada, Yukinori; Shimizu, Taro
• Is Part Of: BMJ case reports. Volume 15:Issue 6(2022)
• Publication Date: 2022-06-10
• Subjects: Cranial nerves -- Medical management; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2022-250364
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A man in his 70s presented with a 4-day history of bilateral frontal headache and heaviness of the face. He was unable to close either of his eyes, to wrinkle his forehead bilaterally and to raise either corner of his mouth. The patient was admitted with a diagnosis of bilateral facial palsy. From history, epidemiology, physical and laboratory findings, Bell's palsy was considered more probable than viral infection, Guillain-Barré syndrome and sarcoidosis. Oral administration of prednisolone, valacyclovir and mecobalamin were initiated promptly, which improved his symptoms. In areas in which Lyme disease is not endemic, we believe that Bell's palsy is the most probable cause of isolated bilateral facial palsy. Patients with bilateral facial paralysis under the suspicion of Bell's palsy should be immediately started on steroid therapy.