What lies beneath a facial nerve palsy? Case report of a facial palsy caused by non-suppurative parotitis

Abstract

Objective: Facial nerve palsy is a common presentation with a variety of causes. We present a relatively uncommon cause. Case presentation: A 54-year-old gentleman presented with a left lower motor neurone facial weakness and an associated ipsilateral large firm, non-tender parotid. An ultrasound was in keeping with parotid sialadenitis without abscess formation. He was treated with oral antibiotics and the left parotid swelling and facial palsy improved. Discussion: Epidemiology dictates that a facial palsy with an associated parotid mass should always be investigated for underlying malignancy, as this remains a more likely presentation. There have been occasional case reports in the literature of this presentation being due to a benign process, such as a parotid abscess. Occasionally, as in this case, the cause may be a non-suppurative parotitis. Infective causes of facial nerve palsy have a good prognosis with likely resolution of the facial palsy.