Report the first case of a bilateral idiopathic facial palsy in a female young patient who received medical management for right side and early surgical decompression for left side, both with successful outcomes.
A case report of a 15-years-old female with bilateral Bell's palsy.
A 15-years-old female presented with right complete facial nerve palsy which two days later progressed to the left side, following an episode of herpetic stomatitis. Right facial paralysis responded well to medical therapy, however left side was refractory to antiviral, steroids and physiotherapy even after two weeks. Secondary etiology was rejected. Radiological imaging that is HRCT mastoid and MRI did not show any dura or nerve sheath enhancement or cerebellopontine angle tumor. Electrophysiological test showed left nerve degeneration. Three weeks after onset of symptoms, left facial nerve decompression was done via transmastoid approach. We succeed in recovering to almost normal facial mobility with electrophysiological test improvement 4 months postoperative.
We present a case of Bell's palsy where two variable clinical courses can be seen with two different treatment options which were successful and improved patient's quality of life.