Bilateral facial paralysis as the sole presenting feature of sarcoidosis: Report of a case

Bilateral facial paralysis is a rare condition and therefore represents a diagnostic challenge. We report the case of a 34-year-old healthy woman with sequential bilateral facial paralysis as a sole manifestation of sarcoidosis. She initially presented with an isolated left sided Bell's palsy without any symptoms to suggest alternative diagnoses. Within a month there was progression to peripheral facial paresis on the contra lateral side, prompting a diagnosis of Lyme disease. Her physical examination and chest x-ray did not reveal any clinical evidence of sarcoidosis. After failing to respond to an empiric trial of intravenous ceftriaxone for a presumptive diagnosis of Lyme disease, computed tomography scan of the chest was ordered which demonstrated bilateral hilar lymphadenopathy. Bronchoscopic biopsy confirmed a diagnosis of sarcoidosis. The patient then made a complete recovery on steroid therapy. We discuss the differential diagnosis of facial diplegia and focus on the clinical presentation, diagnosis and treatment of neurosarcoidosis.

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Isolated bilateral facial palsy due to chicken pox- An unique presentation

Chatterjee¹,

Chatterjee²

2019

Int J Dermatol Clin Res

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A nineteen year old girl presented with lesions of chicken pox and inability to close both eyes properly for two days. She had diffi culty in eating and smiling. Vesicular non pruritic rashes were visible in various stages of healing over face and body except palm and soles. She complained of bilateral headaches but no vomiting, or weakness in her limbs or alteration of her taste sensation. She was alert and cooperative with normal speech and memory. B/L lower motor neuron type of facial nerve palsy was found. Routine blood work up, serology for HIV and Lyme disease, chest x ray, CSF study and MRI brain were normal. She was prescribed 60 mg of prednisolone and 4000 mg of acyclovir every day for 14days. She recovered completely from the neurodefi cit within 14 days.

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Bilateral facial paralysis as the sole presenting feature of sarcoidosis: Report of a case

Cited by 4 publications

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A case presentation of bilateral simultaneous Bell’s palsy

A case presentation of bilateral simultaneous Bell’s palsy

Bilateral facial paralysis

Isolated bilateral facial palsy due to chicken pox- An unique presentation

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