Bilateral seventh nerve palsy

Keane, James R.

doi:10.1212/wnl.44.7.1198

Cited by 190 publications

(110 citation statements)

References 4 publications

Supporting

Mentioning

102

Contrasting

Unclassified

Order By: Relevance

“…8 A review article by Keane found that 2 of 43 cases of bilateral facial nerve palsy were induced by syphilis infection. 7 A potential differential diagnosis of bilateral facial nerve palsy could be syphilitic meningitis, which was reported by Merritt et al to be the most common etiology involving cranial nerves, especially the facial and auditory nerves. 9 In an analysis of 34 patients, unilateral facial nerve involvement was noted in 16 cases, whereas bilateral palsy was observed in 2 cases.…”

Section: Discussionmentioning

confidence: 99%

Bilateral facial nerve palsy as the sole initial symptom of syphilis: a case report

Ting

Wang

Lee³

et al. 2015

CJEM

View full text Add to dashboard Cite

Bilateral facial nerve palsy is an exceedingly rare condition and presents a diagnostic challenge. Bilateral facial nerve palsy may result from cranial trauma, congenital abnormalities, inflammation, infiltration, or infection, but is rarely associated with syphilis. Here, we report a case of syphilis in which bilateral facial nerve palsy was the only initial symptom.A 22-year-old man presented at our emergency department with isolated bilateral facial nerve palsy. Results for initial serum and cerebrospinal fluid examinations were normal, including the rapid plasma reagin titer. One week later, the patient developed rashes on the torso, palms, and soles. At this time, a high serum rapid plasma reagin titer was detected, and the Treponema pallidum particle agglutination test was positive. Once the tests were confirmed, the patient admitted to a history of unprotected sexual behavior. Penicillin G treatment was effective, and a 3-month followup examination demonstrated a complete recovery.We recommend that syphilis be considered when diagnosing sexually experienced young men presenting with bilateral facial nerve palsy, even in the absence of skin manifestations. Failure to recognize facial signs of syphilis could result in inappropriate management, affecting the patient's clinical outcome. RÉSUMÉLa paralysie bilatérale du nerf facial est un trouble extrêmement rare, qui pose des difficultés de diagnostic. La paralysie bilatérale du nerf facial peut résulter d'un traumatisme crânien, d'anomalies congénitales, d'une inflammation, d'une infiltration ou d'une infection, mais elle est rarement associée à la syphilis. Sera exposé ici un cas de syphilis dans lequel la paralysie bilatérale du nerf facial était le seul symptôme initial de la maladie.Un homme de 22 ans est venu consulter au service des urgences pour une paralysie bilatérale et isolée du nerf facial. Les analyses sérologiques et l'examen du liquide céphalorachidien se sont révélés normaux au départ, y compris le test rapide de la réagine plasmatique. Toutefois, une semaine plus tard, des éruptions cutanées sont apparues sur le tronc, la paume des mains et la plante des pieds. Un titre élevé de réagine plasmatique a alors été détecté au test sérologique rapide, et l'épreuve d'agglutination passive de Treponema pallidum s'est avérée positive. Une fois les résultats confirmés, le patient a admis avoir eu un comportement sexuel risqué dans le passé. Le traitement par la pénicilline G a agi efficacement, et l'examen de suivi au bout de 3 mois a permis d'établir l'obtention de la guérison complète.Les auteurs recommandent donc que soit envisagé le diagnostic de syphilis chez les jeunes hommes ayant une vie sexuelle active et présentant une paralysie bilatérale du nerf facial, même en l'absence de manifestations cutanées. Le fait de ne pas reconnaître les signes faciaux de la syphilis pourrait conduire à une prise en charge inadaptée, et se répercuter sur les résultats cliniques.

show abstract

Section: Discussionmentioning

confidence: 99%

Bilateral facial nerve palsy as the sole initial symptom of syphilis: a case report

Ting

Wang

Lee³

et al. 2015

CJEM

View full text Add to dashboard Cite

show abstract

“…In a 23-year review, Keane et al found that out of 43 patients with FD as the predominant sign, GBS were one of the common underlying causes. Among the cases, two out of the five with GBS progressed clinically; information on the others was not available 2 . Eleven patients (64.7%) were diagnosed with GBS in our study, one of them presented with FD at the onset of illness.…”

Section: Discussionmentioning

confidence: 99%

“…Also, the etiology of FD includes many conditions such as congenital, Bickerstaff ' s brainstem encephalitis, tuberculous meningitis, sarcoidosis traumatic, Lyme disease, diabetes mellitus, metabolic, toxic (thallium), and immunoallergic 2,16,17,18,19,20,21,22,23 . In our study, we did not detect Hansen' s disease, syphilis, Lyme disease, intracranial tumors or cryptococcal meningitis, unlike the studies from Keane et al…”

mentioning

confidence: 99%

Facial diplegia: etiology, clinical manifestations, and diagnostic evaluation

Varol

Özdemir

Akıl

et al. 2015

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Objective Facial diplegia (FD) is a rare neurological manifestation with diverse causes. This article aims to systematically evaluate the etiology, diagnostic evaluation and treatment of FD. Method The study was performed retrospectively and included 17 patients with a diagnosis of FD. Results Patients were diagnosed with Guillain-Barré syndrome (GBS) (11), Bickerstaff’s brainstem encephalitis (1), neurosarcoidosis (1), non-Hodgkin’s Lymphoma (1), tuberculous meningitis (1) herpes simplex reactivation (1) and idiopathic (1). In addition, two patients had developed FD during pregnancy. Conclusion Facial diplegia is an ominous symptom with widely varying causes that requires careful investigation.

show abstract

“…A comprehensive review of GBS in pregnancy showed that plasmapheresis and IVIG were both effective and safe in the treatment of GBS in pregnancy. IVIG might be a better choice for GBS during pregnancy because it does not involve important alterations in blood volume (9). GBS per se is not an indication for pregnancy termination because there is evidence that it does not shorten disease duration or improve maternal outcomes (19).…”

Section: Discussionmentioning

confidence: 99%