References

Keane JR. Bilateral seventh nerve palsy: analysis of 43 cases and review of the literature. Neurology. 1994; 44:1198-1202
Kim YH, Choi IJ, Kim HM, Ban JH, Cho CH, Ahn JH. Bilateral simultaneous facial nerve palsy: clinical analysis in seven cases. Otol Neurotol. 2008; 29:397-400
Gilden DH. Clinical practice. Bell's palsy. N Engl J Med. 2004; 351:1323-1331
Jain V, Deshmukh A, Gollomp S. Bilateral facial paralysis: case presentation and discussion of differential diagnosis. J Gen Intern Med. 2006; 21:C7-10
Tahir A, Pokorny P, Malek N. Cephalic tetanus presenting with bilateral facial palsy. Scott Med J. 2019;
Mahto SK, Gupta PK, Singh A, Meena RC. Atypical neurological manifestations of chikungunya fever: two case reports. Ind J Crit Care Med. 2018; 22:306-308
Midon A, Corrêa FB, Maia RD, Sampaio AG, Rosa Júnior M. Bilateral facial paralysis associated with leptospirosis. Radiol Bras. 2018; 51
Yao A, Chan H, Macdonell RAL, Shuey N, Khong JJ. Bilateral facial nerve palsies secondary to chronic inflammatory demyelinating polyneuropathy following adalimumab treatment. Clin Neurol Neurosurg. 2018; 164:64-66
Hamouri S, Al Shorafat D. Bilateral facial nerve paralysis as first presentation of lung cancer. Case Rep Oncol. 2016; 9:792-795

Letters to the Editor

From Volume 46, Issue 8, September 2019 | Page 793

Authors

Wei Cheong Ngeow

Lecturer, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia

Articles by Wei Cheong Ngeow

Article

I refer to the above matter. I read with interest the article entitled ‘Facial palsy: aetiology, diagnosis and management’ by Dr McKernon and colleagues (Dent Update 2019; 46: 565–572). I believe it will benefit your readers if information regarding bilateral occurrence of facial nerve paralysis is also included. Bilateral facial nerve palsy is defined as a paralysis that affects the opposite side within 30 days of the onset of the first side.1

There is no doubt that bilateral facial nerve palsy is a rare phenomenon, if compared to unilateral nerve involvement. It is reported to have an incidence of 1 per 5 million population, occurring in 0.3% to 2.0% of facial palsy cases. Like unilateral peripheral facial palsy, it occurs in both paediatric and adult patients and the aetiology can be either congenital or acquired. However, bilateral facial nerve palsy is idiopathic in only 23% of cases, and an underlying systemic pathology or medical condition, which can be congenital, neurological, infectious, neoplastic, traumatic, or metabolic is often demonstrable.2,3

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