Abstract
Facial nerve palsy can occur from inflammatory, infectious, ischemic, neoplastic, traumatic, idiopathic and dysbaric causes. We present a case of right-sided facial paralysis after scuba diving in an otherwise healthy, 37-year-old experienced female diver. She completed several dives breathing nitrox over six days, with no difficulties. Thirty-five (35) hours after the last dive she flew by commercial aircraft home and reported that she felt normal. Within 48 hours she developed right-sided facial paralysis, in the absence of viral prodrome. Thorough evaluation by emergency medicine and neurology ruled out stroke. She sought hyperbaric medicine consultation, and we suspected idiopathic facial nerve paresis, or Bell’s palsy. Treatment with steroids was initiated and led to a quick and full recovery. With symptom onset soon after diving and flying, this case highlights the importance of considering dysbaric and non-dysbaric diagnoses in divers, while understanding disorders that can mimic decompression sickness.
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