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Differential diagnosis of recurrent or bilateral peripheral facial palsy

Published online by Cambridge University Press:  29 June 2012

D M Oosterveer ,
C P Bénit  and
E L L M de Schryver
D M Oosterveer*
Affiliation:
Sophia Rehabilitation Centre, Delft, The Netherlands
C P Bénit
Affiliation:
Department of Neurology, Westeinde Hospital, The Hague, The Netherlands
E L L M de Schryver
Affiliation:
Department of Neurology, Rijnland Hospital, Leiderdorp, The Netherlands
*
Address for correspondence: Dr D M Oosterveer, Sophia Rehabilitation Centre, Reinier de Graafweg 1, 2625 AD Delft, The Netherlands Fax: +31 15 27 80 219 E-mail: dmoosterveer@hotmail.com
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Abstract

Objective:

To describe the differential diagnosis of recurrent or bilateral peripheral facial palsy.

Method:

Case report and literature review.

Results:

Two patients with recurrent, alternating, peripheral facial palsy are described. In both patients, additional investigation was performed to search for a specific diagnosis. In the first patient, only a positive family history was found, indicating a possible familial susceptibility. In the other patient, diabetes mellitus and hypertension were identified as risk factors.

Conclusion:

There is an important and extensive differential diagnosis of recurrent or bilateral facial palsy. However, in a large proportion of patients the cause remains unknown.

Keywords

Facial PalsyLower Motor Neuron DiseasePeripheral NeuropathyGenetics

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 8 , August 2012 , pp. 833 - 836
Copyright
Copyright © JLO (1984) Limited 2012

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References

1 Peitersen, E. The natural history of Bell's palsy. Am J Otol 1982;4:107–11Google ScholarPubMed
2 Hauser, WA, Karnes, WE, Annis, J, Kurland, LT. Incidence and prognosis of Bell's palsy in the population of Rochester, Minnesota. Mayo Clin Proc 1971;46:258–64Google ScholarPubMed
3 Peitersen, E. Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl 2002;549:4–30 CrossRefGoogle Scholar
4 Pitts, DB, Adour, KK, Hilsinger, RL Jr. Recurrent Bell's palsy: analysis of 140 patients. Laryngoscope 1988;98:535–40CrossRefGoogle ScholarPubMed
5 Cawthorne, T, Haynes, DR. Facial palsy. Br Med J 1956;2:1197–2000 CrossRefGoogle ScholarPubMed
6 Hallmo, P, Elverland, HH, Mair, IWS. Recurrent facial palsy. Arch Otorhinolaryngol 1983;237:97–102 Google Scholar
7 van Amstel, AD, Devriese, PP. Clinical experiences with recurrences of Bell's palsy. Arch Otorhinolaryngol 1988;245:302–6Google Scholar
8 Sherwen, PJ. Bilateral facial nerve palsy: a case study and literature review. J Otolaryngol 1987;16:28–33 Google Scholar
9 Salinas, RA, Alvarez, G, Daly, F, Ferreira, J. Corticosteroids for Bell's palsy (idiopathic facial paralysis). Cochrane Database Syst Rev 2010;3:CD001942CrossRefGoogle Scholar
10 Navarrete, ML, Cespedes, R, Mesa, M, Grasa, J, Perez, M, Raguer, N et al. Recurrent Bell's facial palsy: our experience [in Spanish]. Acta Otorrinolaringol Esp 2001;52:682–6CrossRefGoogle ScholarPubMed
11 Keane, JR. Bilateral seventh nerve palsy: analysis of 43 cases and review of the literature. Neurology 1994;44:1198–202Google Scholar
12 Li, J, Goldberg, G, Munin, MC, Wagner, A, Zafonte, R. Post-traumatic bilateral facial palsy: a case report and literature review. Brain Inj 2004;18:315–20Google Scholar
13 Kumar, S, Gupta, R. Simulaneous bilateral facial palsy as a result of isolated mandibular fractures. Int J Oral Maxillofac Surg 2006;35:1156–9Google Scholar
14 Edgeworth, FH. Case of bilateral facial paralysis, due to injury by forceps at birth. Br Med J 1894;1:11 Google Scholar
15 Vasquez, JC, Shusterman, EM, Hansbrough, JF. Bilateral facial nerve paralysis after high voltage electrical injury. J Burn Care Rehabil 1999;20:307–8Google Scholar
16 Lopez-Lozano, JJ, Merino, JAG, Liano, H. Bilateral facial paralysis secondary to trichinosis. Acta Neurol Scand 1988;78:194–7CrossRefGoogle ScholarPubMed
17 Ropper, AH, Samuels, MA. Adams and Victor's Principles of Neurology, 9th edn. Boston: McGraw-Hill, 2009 Google Scholar
18 Massey, EW, Massey, JM. Facial diplegia due to amyloidosis. South Med J 1986;79:1458–9Google Scholar
19 Nikolaou, AC, Vlachtsis, KC, Daniilidis, MA, Petridis, DG, Daniilidis, IC. Wegener's granulomatosis presenting with bilateral facial nerve palsy. Eur Arch Otorhinolaryngol 2001;258:198–202 Google Scholar
20 Lim, TC, Yeo, WS, Loke, KY, Quek, SC. Bilateral facial nerve palsy in Kawasaki disease. Ann Acad Med Singapore 2009;38:737–8Google Scholar
21 Uchigara, T, Yoshida, S, Tsukagoshi, H. Bilateral facial paresis with Sjögren's syndrome. J Neurol 1989;236:186 Google Scholar
22 Taesdall, RD, Frayha, RA, Shulman, LE. Cranial nerve involvement in systemic sclerosis (scleroderma): a report of 10 cases. Medicine (Baltimore) 1980;59:149–59CrossRefGoogle Scholar
23 Dudley, JP, Goodman, M. Periarteritis nodosa and bilateral facial paralysis. Arch Orolaryngol 1969;90:139–46Google Scholar
24 Cucurachi, L, Cattaneo, L, Gemignani, F, Pavesi, G. Late onset generalized myasthenia gravis presenting with facial weakness and bulbar signs without extraocular muscle involvement. Neurol Sci 2009;Epub ahead of print (PMID:19484183)CrossRefGoogle ScholarPubMed
25 Smith, V, Traquina, DN. Pediatric bilateral facial paralysis. Laryngoscope 1998;108:519–23CrossRefGoogle ScholarPubMed
26 Menassa, J, Sawaya, R, Masri, AF, Arayssi, T. Recurrent peripheral facial paresis may constitute the sole clinical manifestation in neuro-Behcet disease. Neurologist 2008;14:77 Google Scholar
27 Kim, YH, Choi, IJ, Kim, HM, Ban, JH, Cho, CH, Ahn, JH. Bilateral simultaneous facial nerve palsy: clinical analysis in seven cases. Otol Neurotol 2008;29:397–400 CrossRefGoogle ScholarPubMed
28 Ramsey, KL, Kaseff, LG. Role of magnetic resonance imaging in the diagnosis of bilateral facial paralysis. Am J Otol 1993;14:605–9Google ScholarPubMed
29 Mori, E, Kojima, H, Wada, K, Moriyama, H. Middle ear adenoma diagnosed by recurrent facial paralysis. Auris Nasus Larynx 2009;36:75–8Google Scholar
30 Michalopoulos, K, Bajaj, Y, Strachan, DR. Recurrent facial nerve palsy caused by a facial cyst. Br J Hosp Med (Lond) 2008;69:475 Google Scholar
31 Scholz, E, Langer, J, Begall, K. Recurrent facial paresis with facial neurinoma [in German]. Laryngorhinootologie 2007;86:443–7CrossRefGoogle ScholarPubMed
32 Zaytoun, GM, Dagher, WI, Rameh, CE. Recurrent facial nerve paralysis: an unusual presentation of fibrous dysplasia of the temporal bone. Eur Arch Otorhinolaryngol 2008;265:255–9CrossRefGoogle ScholarPubMed
33 Eby, TL, Fisch, U, Makek, MS. Facial nerve management in temporal bone hemangiomas. Am J Otol 1992;13:223–32Google ScholarPubMed
34 Sarkar, S, Deb, AR, Saha, K, Das, CS. Simultaneous isolated bilateral facial palsy: a rare vincristine-associated toxicity. Indian J Med Sci 2009;63:355–8Google Scholar
35 Mallya, KB, Mendis, T, Guberman, A. Bilateral facial paralysis following ethylene glycol ingestion. Can J Neurol Sci 1986;13:340–1Google Scholar
36 Lee, RT, Oster, MW, Balmaceda, C, Hasdorffer, CS, Vahdat, LT, Papadopoulos, KP. Bilateral facial nerve palsy secondary to the administration of high-dose paclitaxel. Ann Oncol 1999;10:1245–7CrossRefGoogle Scholar
37 Thai, XC, Bruno-Murtha, LA. Bell's palsy associated with linezolid therapy: case report and review of neuropathic adverse events. Pharmacotherapy 2006;26:1183–9Google Scholar
38 Metson, R, Hanson, DG. Bilateral facial nerve paralysis following arterial embolization for epistaxis. Otolaryngol Head Neck Surg 1983;91:299–303 Google Scholar
39 Hattori, T, Schlagenhauff, RE. Bilateral facial palsy: occurrence with diabetes mellitus. N Y State J Med 1977;77:1492–3Google Scholar
40 Rice, JP, Horowitz, M, Chin, D. Wernicke-Korsakoff syndrome with bilateral facial nerve palsies. J Neurol Neurosurg Psychiatry 1984;47:1356–7CrossRefGoogle ScholarPubMed
41 Lewis, M, Kallenbach, J, Hockman, M, Zaltzman, M, Zwi, S. Otolaryngological complications of acute porphyria. Laryngoscope 1983;93:483–4Google Scholar
42 Clement, WA, White, A. Idiopathic familial facial nerve paralysis. J Laryngol Otol 2000;114:132–4Google Scholar
43 Döner, F, Kutluhan, S. Familial idiopathic facial palsy. Eur Arch Otorhinolaryngol 2000;257:117–19Google ScholarPubMed
44 Kulkarni, GB, Pal, PK, Shyambabu, C, Kovoor, JM, Senthilkumar, E. Osteopetrosis manifesting as recurrent bilateral facial palsy in childhood: a case report. Clin Neurol Neurosurg 2011;113:230–4CrossRefGoogle ScholarPubMed
45 Salameh, JS, Atassi, N, David, WS. SOD1 (A4V)-mediated ALS presenting with lower motor neuron facial diplegia and unilateral vocal cord paralysis. Muscle Nerve 2009;40:880–2Google Scholar
46 Walling, AD. Bell's palsy in pregnancy and the puerperium. J Fam Pract 1993;36:559–63Google ScholarPubMed
47 Raucq, E, Dupuis, MJ. Facial diplegia after hymenoptera sting. Acta Neurol Belg 1998;98:215–20Google Scholar
48 Roh, JK, Kim, BK, Chung, JM. Combined peripheral facial and abducens nerve palsy caused by caudal tegmental pontine infarction. Eur Neurol 1999;41:99–102 Google Scholar
49 Strauss, MJ. Diplegia facialis in early syphilis: a report of a case. Arch Dermatol Syph 1929;20:306–14Google Scholar
50 Ernster, JA. Bilateral facial nerve paralysis associated with Mycoplasma pneumoniae infection. Ear Nose Throat J 1984;63:585–9Google Scholar
51 Silva, AA, Ducroquet, M, Pedrozo, JC Jr. Bilateral facial palsy associated with leptospirosis. Braz J Infect Dis 2009;13:319–21CrossRefGoogle ScholarPubMed
52 Brown, AJ. Cephalic tetanus with report of a case. Ann Surg 1912;55:473–84Google Scholar
53 Santos, DQ, Adour, KK. Bilateral facial paralysis related to sexually transmitted herpes simplex: clinical course and MRI findings. Otolaryngol Head Neck Surg 1993;108:298–303 CrossRefGoogle ScholarPubMed
54 Jamal, GA, Al-Husaini, A. Bell's palsy and infection with rubella virus. J Neurol Neurosurg Psychiatry 1983;46:678–80Google Scholar
55 Sherman, IC, Kimelblot, SJ. Facial paralysis in poliomyelitis: report of 3 patients with unusual delayed paralysis. Neurology 1959;9:282–7Google Scholar
56 Murakami, S, Mizobuchi, M, Nakashiro, Y, Doi, T, Hato, N, Yanagihara, N. Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle. Ann Intern Med 1996;124:27–30 CrossRefGoogle ScholarPubMed
57 Kochar, DK, Sirohi, P, Kochar, SK, Bindal, D, Kochar, A, Jhajharia, A et al. Post-malaria neurological syndrome – a case of bilateral facial palsy after Plasmodium vivax malaria. J Vector Borne Disease 2007;44:227–9Google Scholar
58 Boahene, DO, Olsen, KD, Driscoll, C, Lewis, JE, McDonald, TJ. Facial nerve paralysis secondary to occult malignant neoplasms. Otolaryngol Head Neck Surg 2004;130:459–65Google Scholar
59 Catalano, PJ, Sen, C, Biller, HF. Cranial neuropathy secondary to perineural spread of cutaneous malignancies. Am J Otol 1995;16:772–7Google Scholar
60 Breadon, GE, Cody, DT, Weiland, LH. Facial palsy: unusual etiology. Laryngoscope 1977;87:26–34 Google Scholar
61 May, M, Hughes, GB. Facial nerve disorders: update 1987. Am J Otol 1987;8:167–80Google Scholar
62 Schwaber, MK, Larson, TC, Zealear, DL, Creasy, J. Gadolinium-enhanced magnetic resonance imaging in Bell's palsy. Laryngoscope 1990;100:1264–9CrossRefGoogle ScholarPubMed
63 Auerbach, SH, Depiero, TJ, Mejlszenkier, J. Familial recurrent peripheral facial palsy: observations of the pediatric population. Arch Neurol 1981;38:463–4Google Scholar
64 Qin, D, Ouyang, Z, Luo, W. Familial recurrent Bell's palsy. Neurology India 2009;57:783–4Google Scholar
65 Smith, CI, Hammarström, L, Sidén, A. No significant association between HLA and Bell's palsy. Tissue Antigen 1978;12:404–6Google Scholar
66 Shibahara, T, Okamura, H, Yanagihara, N. Human leukocyte antigens in Bell's palsy. Ann Otol Rhinol Laryngol Suppl 1988;137:11–13 Google Scholar
67 Schwartz, MS, Tiwari, JL, Rice, DH. Bell's palsy and HLA-DR: a possible association. Arch Otolaryngol Head Neck Surg 1986;112:753–4Google Scholar
68 Savadi-Oskouei, D, Abedi, A, Sadeghi-Bazargani, H. Independent role of hypertension in Bell's palsy: a case-control study. Eur Neurol 2008;605:253–7Google Scholar
69 Harms, MM, Rotteveel, JJ, Kar, NC, Gabreëls, FJ. Recurrent alternating facial paralysis and malignant hypertension. Neuropediatrics 2000;31:318–20Google Scholar