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Case of bilateral Bell’s palsy
  1. Yumi Otaka,
  2. Yukinori Harada and
  3. Taro Shimizu
  1. DepartDepartment of Diagnostic and Generalist Medicine, Dokkyo Medical University, Shimotsuga-gun, Japan
  1. Correspondence to Dr Taro Shimizu; shimizutaro7{at}


A man in his 70s presented with a 4-day history of bilateral frontal headache and heaviness of the face. He was unable to close either of his eyes, to wrinkle his forehead bilaterally and to raise either corner of his mouth. The patient was admitted with a diagnosis of bilateral facial palsy. From history, epidemiology, physical and laboratory findings, Bell’s palsy was considered more probable than viral infection, Guillain-Barré syndrome and sarcoidosis. Oral administration of prednisolone, valacyclovir and mecobalamin were initiated promptly, which improved his symptoms. In areas in which Lyme disease is not endemic, we believe that Bell’s palsy is the most probable cause of isolated bilateral facial palsy. Patients with bilateral facial paralysis under the suspicion of Bell’s palsy should be immediately started on steroid therapy.

  • Cranial nerves
  • Medical management

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  • Contributors YO wrote the draft. YH and TS revised the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.