A Case Report of Recurrent unilateral Bell’s Palsy in young female

Abstract

Most facial palsies comprise of lower motor neuron type or Bell’s palsy. The mean incidence of recurrence of Bell’s palsy is 6.5% and can recur at any age. Although it was first reported in the year 1871, most of its etiology, pathology, management and progression are still neither fully described nor reported. We reported a case of Bell’s palsy in a young Saudi female who was presented with a unilateral recurrent episode of Bell’s palsy. Patient came to the emergency department with facial asymmetry, severe neck pain, loss of sensation on the left side of face and headache, while she was also not responding to oral medications. She was admitted to the hospital for an intravenous treatment and for further evaluation. Her serologic investigation was unremarkable. Similar episode had occurred five years ago as well, which was completely resolved after treatment. Her brain MRI localized T2 and T2 weighted sequence showed hyperintense lesion at the superior anterior aspect of left orbit and could represent lipoma versus hemangioma. Her presenting complaint responded well on IV treatment and patient was discharged on 11th day. She was also referred for plastic and neurosurgery services for the treatment of underlying cause. Recurrent Bell’s palsy is infrequent with etiology not fully elucidated. However, our case emphasizes that the timely medical treatment with regular follow-up is necessary for better prognosis and identification and treatment of underlying cause.