Send to:

Choose Destination
See comment in PubMed Commons below
Otol Neurotol. 2008 Apr;29(3):397-400. doi: 10.1097/mao.0b013e3181656998.

Bilateral simultaneous facial nerve palsy: clinical analysis in seven cases.

Author information

  • 1Department of Otolaryngology, Head and Neck Surgery, Seoul Municipal Boramae Hospital, Seoul National University College of Medicine, Seoul, South Korea.



To analyze clinical manifestations and prognosis of bilateral simultaneous facial nerve palsy (BS-FNP).


: Retrospective case review with current follow-up wherever possible.


: Tertiary referral centers.


Patients (n = 7; 4 women and 3 men; mean age, 37 yr; range, 18-58 yr) diagnosed with BS-FNP at the time of their first visit.


Therapy with systemic corticosteroids and antiviral agents and outpatient follow-up for 1 month to 4 years after discharge.


Assessment of recovery from FNP using the House-Brackmann grading system.


: The occurrence rate of BS-FNP of total FNP cases for the past 10 years was 0.4%. All patients showed palsy more severe than House-Brackmann Grade IV and similar grades of FNP bilaterally. Patients complained of the involvement of the other side within 1 to 6 days of the involvement of 1 side (mean period, 3.4 d). Bell's palsy was the most common cause (5 of 7; 71.4%), the other 2 being infectious mononucleosis and Ramsay Hunt syndrome zoster sine herpete (1 of 7; 14.3% each). Although most patients recovered completely within 1 to 6 months, 1 with a positive Varicella zoster virus immunoglobulin M titer showed bilateral House-Brackmann Grade II FNP after recovery. No recurrence was noted during the follow-up period.


Bell's palsy is the most common cause of BS-FNP in authors' centers. Although BS-FNP may show more severe paralysis, the overall prognosis in most cases is as good as that in unilateral FNP, excluding life-threatening or traumatic cases. Differential diagnosis is very important because the treatment outcome of BS-FNP depends on the cause.

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins
    Loading ...
    Write to the Help Desk