Caisha Nivenia Moses, Wan Syahmi Bin Wan Mohamad, Kamarul Aryffin Bin Baharuddin, Mohamad Masykurin Bin Mafauzy, Mohd Faiz Bin Mohd Shukri

Department of Emergency Medicine, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia

Keywords: Bell’s palsy, bilateral facial nerve palsy, corticosteroids, electromyography, Guillain–Barré syndrome, idiopathic facial palsy

Abstract

A 32 year old male presented with a 2 week history of progressive bilateral facial weakness, initially diagnosed as unilateral Bell’s palsy. Upon development of bilateral symptoms, further investigations revealed normal hematological, biochemical, and imaging results, ruling out common infectious and autoimmune causes. Electromyography and nerve conduction studies were normal, and lumbar puncture results excluded Guillain–Barré syndrome. The patient was ultimately diagnosed with idiopathic bilateral facial nerve palsy (FNP) after exhaustive exclusion of other etiologies. Treatment with corticosteroids led to symptomatic improvement. This case underscores the importance of a systematic approach in diagnosing rare presentations of FNP and highlights the favorable prognosis with appropriate management.

How to cite this article: Moses CN, Mohamad WS, Baharuddin KA, Mafauzy MM, Shukri MF. Navigating the complexities of bilateral facial nerve palsy: A case report. Turk J Emerg Med 2025;25:239-41.

Author Contributions

CNM: Conceptualization (lead); Writing - Original draft (lead); Writing - Review and editing (equal) WS: Writing - Review and editing (equal); Writing - Original draft (supporting) KABB: Writing - Review and editing (equal) MMBM: Writing - Original draft (supporting) MFB: Writing - Review and editing (equal).

Conflict of Interest

None Declared.

Financial Disclosure

None.

Acknowledgments

We would like to express our sincere gratitude to the patient for his cooperation and consent to participate in this case report. We extend our appreciation to the medical and nursing staff involved in the care and management of the patient. We acknowledge the support of our institution for providing the necessary resources for the successful completion of this case report.