Bilateral Facial Nerve Palsy: A Rare Presentation

Introduction- Bilateral facial paralysis is a rare condition. It may manifest either simultaneous or alternating form and it represents the .3-2% patients of all cases of facial nerve palsy. Majority of these cases have some underlying medical condition. Bell’s palsy accounts for only 23% of bilateral facial paralysis. Case report-A young male patient of 18 yrs presented in ENT OPD with history of difficulty in chewing, impaired facial movements, incomplete eye closure bilaterally. Haematology, serum biochemistry, chest x-ray, MRI brain were normal. Discussion- There may be some serious underlying disease responsible for bilateral facial nerve palsy. However etiology may be congenital, traumatic, infectious, neurological, metabolic, neoplastic, toxic, vascular, and idiopathic. A complete head neck and neurological examination should be done. Conclusion- Bilateral facial palsy is a rare condition and it may present as alternative or simultaneous bilaterally. Careful history and detailed examination is to be done. Its very important to consider all the possible differential diagnosis, to perform relevant lab. And radiological Investigations to reach up to the underlying etiology. However prognosis is good.