A Case Report of Functional Acupuncture in the Treatment of Senile Left Persistent Facial Paralysis

Facial nerve aplasia is an extremely rare condition that is usually syndromic, namely, in Moebius syndrome. The occurrence of isolated agenesis of facial nerve is even rarer, with only few cases reported in the literature. We report a case of congenital facial paralysis due to facial nerve aplasia diagnosed on MRI, while no noticeable abnormality was detected on the temporal bone CT.

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Bilateral temporal bone fractures: a case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175640 ◽

2017 ◽

Vol 4 (1) ◽

pp. 271

Author(s):

Kiran Natarajan ◽

Koka Madhav ◽

A. V. Saraswathi ◽

Mohan Kameswaran

Keyword(s):

Hearing Loss ◽

Case Report ◽

Facial Nerve ◽

Temporal Bone ◽

Facial Paralysis ◽

Bone Fractures ◽

Clinical Manifestations ◽

Csf Leak ◽

The Right ◽

Temporal Bones

<p>Bilateral temporal bone fractures are rare; accounting for 9% to 20% of cases of temporal bone fractures. Clinical manifestations include hearing loss, facial paralysis, CSF otorhinorrhea and dizziness. This is a case report of a patient who presented with bilateral temporal bone fractures. This is a report of a 23-yr-old male who sustained bilateral temporal bone fractures and presented 18 days later with complaints of watery discharge from left ear and nose, bilateral profound hearing loss and facial weakness on the right side. Pure tone audiometry revealed bilateral profound sensori-neural hearing loss. CT temporal bones & MRI scans of brain were done to assess the extent of injuries. The patient underwent left CSF otorrhea repair, as the CSF leak was active and not responding to conservative management. One week later, the patient underwent right facial nerve decompression. The patient could not afford a cochlear implant (CI) in the right ear at the same sitting, however, implantation was advised as soon as possible because of the risk of cochlear ossification. The transcochlear approach was used to seal the CSF leak from the oval and round windows on the left side. The facial nerve was decompressed on the right side. The House-Brackmann grade improved from Grade V to grade III at last follow-up. Patients with bilateral temporal bone fractures require prompt assessment and management to decrease the risk of complications such as meningitis, permanent facial paralysis or hearing loss. </p>

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P.029 Case report: Facial diplegia and aseptic meningitis in a 44 year-old man returning from Côte d’Ivoire

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2016.134 ◽

2016 ◽

Vol 43 (S2) ◽

pp. S28-S28

Author(s):

HA AlDhukair ◽

R Altman ◽

A Parks ◽

MP Cheng ◽

A Damian

Keyword(s):

Case Report ◽

Facial Paralysis ◽

Aseptic Meningitis ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Facial Diplegia ◽

Rare Manifestation ◽

Hiv Seroconversion

Background: Bilateral facial paralysis is a rare manifestation of Human Immunodeficiency Virus (HIV). Few cases of HIV seroconversion syndrome presenting with aseptic meningitis and facial diplegia have been previously reported. Methods: Case Report. Case Description: A 44-year-old male with uncontrolled hypertension who presented with 5-day history of migrainous headache, bucco-labial dysarthria, meningismus and dysguesia. Three weeks prior to presentation, he suffered a transient febrile illness preceded by an unprotected sexual encounter while vacationing in Côte d’Ivoire. Examination was significant for hypertensive urgency, bilateral lower motor neuron (LMN) facial paralysis, and meningeal irritation. Investigations revealed acute on chronic renal impairment and left ventricular hypertrophy. Brain MRI (without contrast) revealed microhemorrhages with dystrophic calcifications and microangiopathic changes. CSF analysis revealed 55 WBC (lymphocytic), normal glucose, and 0.67g/L protein. The infectious work-up was positive for HIV, which was confirmed by Western Blot (WB). CD4 count was 176 cells/μL and the viral load was 419,289 copies/ml. Lyme antibodies were also positive by enzyme-linked immunosorbent assay (ELISA), but negative by WB. Discussion: Facial diplegia is a rare manifestation of HIV, and can be indicative of a seroconversion syndrome. This case illustrates another layer of complexity; deciphering acute from chronic systemic manifestations of hypertension, and appreciating falsely positive Lyme antibodies by ELISA during acute HIV seroconversion.

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