Contralateral Recurrence of Idiopathic Facial Nerve Palsy: A Case Report

Le résumé fourni par la source

Bell palsy, a form of acute peripheral facial palsy, presents as unilateral facial paralysis or weakness due to dysfunction of the facial nerve. Cases in which there is no detectable cause of this are referred to as Bell palsy. Generally, Bell palsy presents as a sudden, unilateral weakness of facial muscles, clinically distinguished by mouth drooping, inability to wrinkle the forehead or close the eye, or paresthesias. It is possible that these symptoms are preceded by dysgeusia, drooling, hyperacusis, and decreased ability to form tears. Though Bell palsy is often regarded as a diagnosis of exclusion, there are several theories behind its etiology: anatomic causes, acute/latent viral infection, ischemia, inflammation, and cold stimulation1. This report discusses the case of a 62-year-old African American female presenting with two separate instances of Bell palsy, with the second episode occurring contralaterally to the side affected in the primary episode. Bell palsy recurs in 4-14% of patients, with recurrences most commonly associated with a family history of the condition2. Aside from the novelty of general recurrence of the condition, according to Chweya et al., at a single tertiary academic center between the years 2000 and 2017, only 53 patients were documented to have experienced recurrence of their idiopathic facial paralysis, with 22 of the recurrence cases being strictly ipsilateral and the remaining 31 patients having experienced at least one episode of contralateral recurrent Bell palsy. The goal of this case study is to describe an uncommon and clinically significant presentation of Bell palsy and explore comorbidities and pertinent history that may impact the contralateral nature of this patient’s second instance of Bell palsy

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