A Case of Bilateral Simultaneous Facial Palsy

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We report on a case of bilateral simultaneous facial palsy in a fifty-year-old man. One day, after symptoms of a common cold and involuntary movements of the right cheek, the patient became unable to close his right eye and mouth. Two days later, he also noticed the hypokinesis of the left side of his face, and consulted us. He was diagnosed with bilateral simultaneous facial palsy. We could not find any disorders of the central nervous system, but we found that he was suffering from poorly controlled diabetes mellitus (DM) which also can cause the nerve palsy. In addition to this, we found herpes simplex virus (HSV) titer elevation. HSV is reported to associate with idiopathic facial palsy (Bell's palsy). We concluded that the etiology of his bilateral simultaneous facial palsy was caused by the infection of HSV based on poorly controlled DM. Bilateral stellate ganglion block with 6ml of 1% mepivacaine was performed on the both sides on every day for 50 days. Predonisolone was administered orally for 3 weeks, and insulin was given for the treatment of DM. Bilateral facial palsy disappeared completely 6 months after the start of the therapy.
一般社団法人日本ペインクリニック学会の論文