Pothiawala Sohil, Lateef Fatimah
Department of Emergency Medicine, Singapore General Hospital, Outram Road, Singapore 169608.
Case Rep Emerg Med. 2012;2012:458371. doi: 10.1155/2012/458371. Epub 2012 Jan 23.
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.
引言。双侧面神经麻痹（FNP）是一种罕见病症，占所有面神经麻痹病例的比例不到2%。这些患者中的大多数都有潜在的疾病，范围涵盖神经、感染、肿瘤、创伤或代谢紊乱等病症。目的。其病因的鉴别诊断范围广泛，因此可能构成诊断挑战。急诊医生应了解这些各种诊断可能性，其中一些可能是致命的。病例报告。我们报告一例43岁女性患者，她因先后出现双侧面神经麻痹就诊于急诊科，该病症无法归因于任何特定病因，因此造成了诊断困境。结论。我们强调在所有出现双侧FNP的病例中考虑鉴别诊断范围的重要性。这些患者需要住院，并迅速进行实验室和影像学检查，以评估潜在病因并进行相关的具体进一步治疗。
