Jain Aditya, Ranganathan Rajeshwar, Sinha Abhishek, Rangoonwala Abizar, Kohul Subramaniam
Emergency Medicine, United Lincolnshire Hospitals NHS Trust, Boston, GBR.
Cureus. 2024 Sep 10;16(9):e69093. doi: 10.7759/cureus.69093. eCollection 2024 Sep.
Bell's palsy, an acute, idiopathic, and typically unilateral facial nerve paralysis, represents a common cause of sudden facial weakness. The aetiology is often attributed to viral infections. This case report discusses the presentation, diagnosis, and management of a rare case of idiopathic bilateral Bell's palsy. We present a case of a 31-year-old male who presented to the emergency department with a one-week history of progressive bilateral facial weakness following initial neck and jaw pain. Despite the resolution of pain, the patient experienced complete facial paralysis on both sides, including the inability to raise eyebrows, close eyes fully, and numbness over the lips. The patient presented with no complaints of headache, trauma, vision changes, or recent travel history. Examination and routine blood tests yielded normal results, and a head CT scan showed no abnormalities. As a result, the diagnosis of idiopathic bilateral Bell's palsy was confidently confirmed. This case highlights the clinical presentation, diagnostic approach, and management of a rare bilateral facial palsy, emphasizing the importance of a comprehensive evaluation and considering Bell's palsy in differential diagnoses of acute facial weakness.
贝尔麻痹是一种急性、特发性且通常为单侧的面神经麻痹，是导致突然面部无力的常见原因。其病因常被认为与病毒感染有关。本病例报告讨论了一例罕见的特发性双侧贝尔麻痹的临床表现、诊断及治疗。我们报告一例31岁男性患者，该患者因颈部和下颌疼痛一周后出现进行性双侧面部无力而就诊于急诊科。尽管疼痛已缓解，但患者双侧面部完全瘫痪，包括无法抬眉、完全闭眼以及嘴唇麻木。患者无头痛、外伤、视力变化或近期旅行史等主诉。体格检查及常规血液检查结果均正常，头部CT扫描未发现异常。因此，特发性双侧贝尔麻痹的诊断得以明确。本病例突出了罕见双侧面神经麻痹的临床表现、诊断方法及治疗，强调了全面评估的重要性以及在急性面部无力的鉴别诊断中考虑贝尔麻痹的必要性。
