Publication:

Bilateral facial nerve palsy: challenges in diagnosis

Bilateral facial palsy is a rare condition accounting for less than 2% of all cases of facial nerve palsy. Most of the patients develop bilateral facial nerve palsy secondary to underlying medical condition, which can be neurologic, infectious, traumatic, neoplastic or metabolic disorder. Clinicians should be careful enough to face the diagnostic dilemma and to rule out wide range of differential diagnosis in these cases, some of which can be potentially fatal. Treatment should be initiated according to the diagnosis. We are reporting a case of 26 year old man who presented to our ENT OPD with bilateral facial nerve palsy. The condition could not be attributed to any particular aetiology hence presented a diagnostic dilemma. We endorse the practice of considering wide range of differential diagnosis in all case of bilateral facial nerve palsy. These patients should undergo prompt laboratory and radiological investigations and gruelling evaluation of underlying cause for further specific management.