BILATERAL FACIAL NERVE PALSY IN A 65-YEAR-OLD WOMAN
A CASE REPORT
2000 Volume 43 Issue 1 Pages 54-58
Details
2000 Volume 43 Issue 1 Pages 54-58
A 65-year-old woman had sudden onset of bilateral facial palsy.Initially, the patient showed disturbance of movement on the right side of the face, which improved by administering steroid hormone by intravenous infusion. However, 31 days later, the patient developed facial palsy, on the left side of the face. Once again, steroid hormone was administred intravenously, and the patient's condition recovered normal facial movement.
Clinical examination revealed unremarkable physical characteristics except for the facial palsy. Chemical analysis of blood showed normal values. Both radiographic and magnetic resonance imaging (MRI) examinations of the ear demonstrated normal results. However, serological analysis revealed high antibody titers to herpes simplex virus (HSV) and to cytomegalo virus (CMV).
Therefore, we were unable to rule out the possibility that the facial palsy may have resulted from a viral infection. Nevertheless, we strongly believe that the definitive diagnosis should include viral infection.
Bilateral facial palsy is a rare condition. We diagnosed this case as bilateral heterochronous facial palsy.
The majority of bilateral facial palsies are caused by Bell's palsy. However, we believe that it is necessary to also consider other causes such as systemic diseases, and sarcoidosis.
