From the Guidelines
The most common cause of bilateral facial nerve palsy is Lyme disease 1.
Potential Causes
- Guillain-Barré syndrome
- Sarcoidosis
- Infections such as varicella-zoster virus
- Certain medications, such as isoniazid, an antituberculosis medication
- Conditions like multiple sclerosis or tumors 1.
Treatment
If suspected, treatment with corticosteroids, such as prednisone 60-80 mg per day for 5-7 days, may be initiated to reduce inflammation and swelling. Additionally, if Lyme disease is suspected, treatment with antibiotics such as doxycycline 100 mg twice a day for 2-4 weeks or ceftriaxone 2 grams per day for 2-4 weeks may be necessary 1. It is essential to consult a healthcare professional for proper diagnosis and treatment, as bilateral facial nerve paresis or paralysis is atypical of Bell’s palsy and may warrant additional specialized and more extensive laboratory testing 1.
From the Research
Causes of Bilateral Facial Nerve Palsy
The most common causes of bilateral facial nerve palsy include:
- Bell's palsy: considered the most probable cause in areas where Lyme disease is not endemic 2
- Lyme disease: a common cause of bilateral facial nerve palsy, especially in endemic regions 3, 4, 5, 6
- Guillain-Barré syndrome: a rare cause of bilateral facial nerve palsy 3
- Leukemia: a rare cause of bilateral facial nerve palsy 3
- Möbius syndrome: a rare cause of bilateral facial nerve palsy 3
- Neurofibromatosis type 2: a rare cause of bilateral facial nerve palsy 3
- Brain tumor: a rare cause of bilateral facial nerve palsy 3
- Melkersson-Rosenthal syndrome: a rare cause of bilateral facial nerve palsy 3
- Bilateral temporal bone fractures: a rare cause of bilateral facial nerve palsy 3
- Central nervous system lymphoma: a rare cause of bilateral facial nerve palsy 3
- Human immunodeficiency virus infection: a rare cause of bilateral facial nerve palsy 3
Prevalence of Causes
According to a study, the prevalence of causes of bilateral facial nerve palsy is: