Multiple sclerosis facial paralysis











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Diagnosis And Treatment Of Facial Palsy

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Congenital vs acquired facial palsy

Original communication. Authors Authors and affiliations T. A year-old patient presented to the emergency department complaining of brief episodes of vertigo and nausea with vomiting, which had occurred the day before. Overview of the epidemiology, diagnosis, and disease progression associated with multiple sclerosis. Lying still, the vertigo reduced. Brain MRI showed disseminated supra- and infratentorial white matter lesions, which included also lesions at the level of the pons. J Neurol Neurosurg Psychiatry. Discussion Isolated idiopathic peripheral facial palsy Bell's palsy is considered to be a disease of the peripheral nervous system, while MS is defined as a disease of the central nervous system [ 1 , 6 ]. He was further not able to furrow his right forehead and complained of right-sided tinnitus and numbness of the right side of his face. Pontine stroke presenting as isolated facial nerve palsy mimicking Bell's palsy. Blood examination was normal for full blood count. Author information Copyright and License information Disclaimer. However, in light of the reported episodes of vertigo and nausea pointing to a brain stem lesion, we decided to perform a brain MRI that showed three demyelinating lesions in the supratentorial, periventricular region. Facial palsy was usually associated with other brainstem signs, while two patients showed only facial palsy 1 and 3 years after the onset of MS.

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Description: The patient's past history was remarkable for pneumonia and a traumatic spinal fracture, from which he had fully recovered. During the last decades, only a few cases on the association between peripheral demyelinating diseases and multiple sclerosis MS have been reported. Critchley [ 9 ] presented a case of a year-old woman with a right-sided facial palsy. This particularity in neuronal connectivity explains why a unilateral supranuclear lesion, contrary to an infranuclear lesion, does not affect the muscles of the forehead and leads only to lower facial paralysis [ 6 , 7 , 8 ]. We observed residual signs of facial palsy in five other patients in whom acute onset was confirmed from medical records. Overview of the epidemiology, diagnosis, and disease progression associated with multiple sclerosis. Case Report A year-old patient presented to the emergency department complaining of brief episodes of vertigo and nausea with vomiting, which had occurred the day before. MS lesions are confined to the central nervous system and consequently not extending the nerve root entry zone [ 5 ]. Auditory evoked potentials were normal. The difficulty in promptly establishing the diagnosis in our patient was not due to the circumstance that he had both, i. We describe the case of a young man who was initially diagnosed with Bell's palsy, and only after performing a brain MRI was the diagnosis of MS made. Imaging the facial nerve. Conclusion Although the GDG group recommends that clinicians should not routinely perform diagnostic imaging for patients with new-onset Bell's palsy, except when there are some evident clinical findings that would warrant imaging [ 13 ], performing a brain MRI may well be necessary in all cases of peripheral-appearing nerve palsies. Facial palsy occurred in 21 Clinical practice guideline.
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