scholarly journals Bilateral facial nerve palsy as the sole initial symptom of syphilis: a case report

CJEM ◽  
2015 ◽  
Vol 17 (5) ◽  
pp. 576-581 ◽  
Author(s):  
Chi-Hsin Ting ◽  
Chih-Wei Wang ◽  
Jiunn-Tay Lee ◽  
Giia-Sheun Peng ◽  
Fu-Chi Yang
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Rare Condition ◽  
Complete Recovery ◽  
High Serum ◽  
Penicillin G ◽  
Initial Symptom ◽  
Rapid Plasma Reagin ◽  
Diagnostic Challenge

AbstractBilateral facial nerve palsy is an exceedingly rare condition and presents a diagnostic challenge. Bilateral facial nerve palsy may result from cranial trauma, congenital abnormalities, inflammation, infiltration, or infection, but is rarely associated with syphilis. Here, we report a case of syphilis in which bilateral facial nerve palsy was the only initial symptom.A 22-year-old man presented at our emergency department with isolated bilateral facial nerve palsy. Results for initial serum and cerebrospinal fluid examinations were normal, including the rapid plasma reagin titer. One week later, the patient developed rashes on the torso, palms, and soles. At this time, a high serum rapid plasma reagin titer was detected, and the Treponema pallidum particle agglutination test was positive. Once the tests were confirmed, the patient admitted to a history of unprotected sexual behavior. Penicillin G treatment was effective, and a 3-month follow-up examination demonstrated a complete recovery.We recommend that syphilis be considered when diagnosing sexually experienced young men presenting with bilateral facial nerve palsy, even in the absence of skin manifestations. Failure to recognize facial signs of syphilis could result in inappropriate management, affecting the patient’s clinical outcome.

scholarly journals Bilateral Facial Nerve Palsy: A Diagnostic Dilemma

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sohil Pothiawala ◽  
Fatimah Lateef
Keyword(s):  
Differential Diagnosis ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Rare Condition ◽  
Facial Nerve Paralysis ◽  
Diagnostic Challenge ◽  
Radiological Investigation ◽  
Diagnostic Dilemma ◽  
Nerve Paralysis

Introduction. Bilateral facial nerve palsy (FNP) is a rare condition, representing less than 2% of all cases of FNP. Majority of these patients have underlying medical conditions, ranging from neurologic, infectious, neoplastic, traumatic, or metabolic disorders.Objective. The differential diagnosis of its causes is extensive and hence can present as a diagnostic challenge. Emergency physicians should be aware of these various diagnostic possibilities, some of which are potentially fatal.Case Report. We report a case of a 43-year-old female who presented to the emergency department with sequential bilateral facial nerve paralysis which could not be attributed to any particular etiology and, hence, presented a diagnostic dilemma.Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological investigation for evaluation of the underlying cause and specific further management as relevant.

Predicting recovery of facial nerve function following injury from a basilar skull fracture

1991 ◽  
Vol 75 (5) ◽  
pp. 759-762 ◽  
Author(s):  
Andrew B. Adegbite ◽  
Moe I. Khan ◽  
L. Tan
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Recovery Of Function ◽  
Statistical Significance ◽  
Complete Recovery ◽  
Partial Recovery ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Partial Lesion

✓ Twenty-five patients with posttraumatic facial nerve palsy were studied. Partial recovery of function had occurred in 95% of these patients by 18 months after injury. At 5 months posttrauma, there was some recovery in 92.5% of those with a partial lesion compared with 10% of those with a complete lesion. This difference attains statistical significance. Complete recovery of nerve function had occurred by 10.5 months in 53.5% of the patients; in 62% of patients with a partial lesion, complete recovery had occurred by 4 months compared with 0% in those with a complete lesion. This difference also attains statistical significance. There was no statistically significant difference in recovery of function between patients with an immediate as opposed to a delayed onset of facial nerve palsy. It was determined that the degree of palsy had a statistically significant influence on recovery of facial nerve function, whereas the time of onset did not. The data presented support a conservative approach to these injuries and it is recommended that the possibility of surgical treatment should be entertained in patients with complete facial palsy persisting for 12 to 18 months after injury.

scholarly journals Facial nerve palsy as an unusual presentation of orbital apex syndrome

2021 ◽  
Vol 17 (2) ◽  
pp. 176-179
Author(s):  
Rafiqahmed Abdulkarim Vasiwala ◽  
◽  
Wong Zhen Yu ◽  
Tee Chen Giap ◽  
Ashiya Rafiq ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Multidisciplinary Approach ◽  
Facial Nerve Palsy ◽  
Unusual Presentation ◽  
Diabetic Patients ◽  
Fungal Sinusitis ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Diagnostic Challenge

Clinical cases of orbital apex syndrome are rare and most commonly manifested as a complication of fungal sinusitis, mainly in immunocompromised and poorly controlled diabetic patients. Rhino-orbital mucormycosis is a rare opportunistic, aggressive and fatal infection caused by mucor. The complex presentation of orbital apex syndrome not only poses a diagnostic challenge but also demands a multidisciplinary approach in patient management. Facial nerve palsy is an unusual presentation in orbital apex syndrome. We report the case of a 64-year-old diabetic patient presenting with ophthalmoplegia and visual loss associated with facial nerve palsy. Prompt ophthalmologic and otolaryngologic intervention with imaging and histologic confirmation, followed by early initiation of antifungal and antimicrobial therapy, were integral to preventing further complications, and reducing morbidity and mortality.

scholarly journals Tubercular otomastoiditis presenting with Citelli’s abscess

2021 ◽  
Vol 7 (9) ◽  
pp. 1544
Author(s):  
Lham Dorjee ◽  
Manu C.B. ◽  
Suvamoy Chakraborty ◽  
Abijeet Bhatia
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Chronic Otitis Media ◽  
Bone Destruction ◽  
Rare Condition ◽  
High Resolution Computed Tomography ◽  
Anti Tubercular Therapy ◽  
The Right

<p class="abstract">Tuberculosis (TB) of the temporal bone is a rare condition. Tubercular otomastoiditis presenting with Citelli’s abscess, facial nerve palsy and extensive bone destruction is an unusual condition. As far as we know this maybe the first reported case with the above diagnosis. A 26 year old male patient presented with chronic right ear discharge, decreased hearing and right side facial nerve palsy with tender fluctuant swelling in the right post aural region approximately 10×8 cm in dimension, posterior to the mastoid tip and extending into the occipital region, almost reaching up to the midline posteriorly. High resolution computed tomography (CT) scan of temporal bone and magnetic resonance imaging (MRI) of brain was done. He underwent right side mastoid exploration and drainage of the abscess under general anaesthesia. The specimens sent for investigations revealed acid fast bacilli suggestive of <em>Mycobacterium tuberculosis</em> and the patient was started on anti-tubercular therapy. In all cases of long-standing chronic otitis media (COM) especially in those with complications, possibility of TB should be ruled out. High index of suspicion is needed for early diagnosis and treatment and to prevent dreaded complications in such patients.</p>

Facial nerve baroparesis during airflight: a case report and literature review

2020 ◽  
pp. 1-5
Author(s):  
M Alwan ◽  
M Gordan
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Reference Lists ◽  
Facial Nerve Palsy ◽  
Rare Condition ◽  
Tube Insertion ◽  
Rare Phenomenon ◽  
Middle Ear Pressure ◽  
Tube Dysfunction ◽  
Meta Analyses

Abstract Background Facial nerve baroparesis is a rare phenomenon which has been reported during flight. It is thought to occur due to ischaemic neuropraxia on the facial nerve as middle-ear pressure increases in the presence of Eustachian tube dysfunction and force is transmitted through a dehiscent facial nerve canal. Method This study presents an aviation-associated, right-sided facial nerve palsy as well as presenting the results of a systematic review that was performed on the available literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Full-text articles from Medline, PubMed and Embase were used, as well as associated reference lists. This study systematically reviews the literature to discuss presentation, investigations performed and an approach to management of this rare condition. Results This study identified 23 cases in the literature (including the case presented in this study) of facial nerve baroparesis. Conclusion Facial nerve baroparesis is a mostly temporary rare phenomenon that can be managed effectively with ventilation tube insertion. In the event of long-standing facial nerve palsy after descent of the aircraft, urgent myringotomy should be performed to prevent permanent facial nerve damage.

scholarly journals Lower motor neuron facial palsy secondary to parotid abscess - first sign of uncontrolled diabetes mellitus: a case report

2020 ◽  
Vol 6 (6) ◽  
pp. 1206
Author(s):  
Lakshmi Menon Ravunniarth ◽  
Safina Kauser
Keyword(s):  
Diabetes Mellitus ◽  
Case Report ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Facial Palsy ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Mouth Opening ◽  
Rare Condition ◽  
Uncontrolled Diabetes

<p class="abstract">Facial paralysis associated with parotid disease is usually caused by a malignant process. Facial nerve palsy due to parotid gland abscess is very rare with only about 10 previously reported cases. Parotid abscess with facial palsy may be the first presenting symptom of underlying diabetes mellitus. We report a case of a 35-year-old man, not a known case of diabetes or hypertension, who presented with a right sided parotid abscess and difficulty in mouth opening with grade 4 facial nerve palsy, who on investigation was found to have underlying uncontrolled diabetes mellitus. Parotid abscess is mainly seen in elderly, diabetic and immunocompromised. Facial nerve palsy secondary to parotid abscess is a rare condition but probably underreported. Facial nerve palsy associated with parotid abscess is rare and may be one of the first presenting feature of uncontrolled diabetes mellitus.</p>

scholarly journals Carcinoma Middle Ear with Facial Nerve Palsy and Temporal Lobe Abscess

2013 ◽  
Vol 4 (2) ◽  
pp. 49-51
Author(s):  
M Alamgir Chowdhury ◽  
SM Golam Rabbani ◽  
Md. Asaduzzaman ◽  
Mousumi Malakar
Keyword(s):  
Squamous Cell Carcinoma ◽  
Facial Nerve ◽  
Cell Carcinoma ◽  
Temporal Lobe ◽  
Middle Ear ◽  
Squamous Cell ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Rare Condition ◽  
Suppurative Otitis Media

Carcinoma of middle ear is very rare condition being one in 20,000 new patients. The commonest primary middle ear malignancy is usually squamous cell carcinoma. A 36-year-male presented with right sided severe earache with blood stained aural discharge, associated with headache and deviation of angle of the mouth to the opposite side. He had ear discharge since childhood. On examination he had bleeding polypoidal mass in the right external auditory canal & tympanic membrane was not visualized. He also had features of facial nerve palsy. CT scan of brain finding was chronic right mastoiditis & right temporal lobe abscess causing significant mass effect. The patient was undergone Burr-hole operation. After 2 weeks right radical mastoidectomy was done. There was huge granulation tissue involving middle ear, attic & mastoid antrum and ossicles was eroded. Histopathology report revealed infiltrating squamous cell carcinoma grade-I. The patient was sent for radiotherapy & asked for follow up monthly. In long standing chronic suppurative otitis media with blood stained discharge & facial nerve palsy, middle ear malignancy should be suspected. Anwer Khan Modern Medical College Journal Vol. 4, No. 2: July 2013, Pages 49-51 DOI: http://dx.doi.org/10.3329/akmmcj.v4i2.16943

scholarly journals A case of cephalic tetanus with facial nerve palsy as an initial symptom in an elderly patient

2009 ◽  
Vol 55 (10) ◽  
pp. 490-494 ◽  
Author(s):  
Atsushi NISHIKAWA ◽  
Yasumitsu KODAMA ◽  
Takayoshi SHIMOHATA ◽  
Hisashi OHNUKI ◽  
Masatoyo NISHIZAWA ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Initial Symptom ◽  
Cephalic Tetanus

scholarly journals Bilateral Post Traumatic Facial Nerve Palsy Presenting as Dysarthria: A Case Report

2020 ◽  
pp. 1-3
Author(s):  
Ekuma ME ◽  
Ekuma ME ◽  
Ndubuisi CA ◽  
Mezue W ◽  
Ohaegbulam SC ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Bone Fracture ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Road Traffic ◽  
Brain Mri ◽  
Complete Recovery ◽  
Temporal Bone Fracture ◽  
Motor Neuron Facial Nerve

Bilateral traumatic facial nerve palsy (FNP) is rare and can present with distressing features. We report a 23-year-old male final year medical student with a 10-day history of speech difficulty following a passenger motorcycle road traffic accident. Physical examination showed a fully conscious young man whose only neurological deficit was bilateral lower motor neuron facial nerve palsy (House and Brackmann grade IV) and difficulty pronouncing plosives. A high-resolution temporal bone CT showed a right longitudinal temporal bone fracture. There was no temporal bone fracture on the left side. Brain MRI was normal. He had complete recovery of facial nerve function on conservative management 6 months after the injury.

Benign Adenoma of the Middle Ear Cavity Causing Facial Paralysis

1981 ◽  
Vol 89 (4) ◽  
pp. 624-628 ◽  
Author(s):  
Gerald D. Zahtz ◽  
Benjamin Zielinski ◽  
Allan L. Abramson
Keyword(s):  
Facial Nerve ◽  
Facial Paralysis ◽  
Middle Ear ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Chronic Otitis Media ◽  
Complete Recovery ◽  
Radical Mastoidectomy ◽  
First Case ◽  
Benign Adenoma

The otologic surgeon infrequently encounters tumors confined to the middle ear cavity. A 30-year-old man had a right facial nerve palsy that was believed to be secondary to chronic otitis media. At surgical exploration, an adenoma of the middle ear involving the ossicles and overlying the facial nerve was found, a radical mastoidectomy performed, and subsequent complete recovery of the facial nerve noted. To our knowledge, this is the first case of a middle ear benign adenoma causing a facial paralysis and the pathology, cause, and differential diagnosis will be discussed.

Sign in / Sign up

Export Citation Format

Share Document