A case of Bell's palsy associated with blepharospasm

Abstract

Background: Bell's palsy is the most common acute mononeuropathy, with an incidence of 20 to 30 cases per 100,000 people per year.

Objectives: Blepharospasm associated with Bell's palsy has been rarely reported. We describe an unusual presentation of Bell's palsy associated with blepharospasm.

Case report: A 44-year-old man presented to the Emergency Department with a few hours' history of right eye blepharospasm. His cornea and conjunctiva were normal on slit lamp examination, including fluorescein staining. His cranial nerves were intact except for a complete right facial nerve weakness, with the patient unable to raise his right eyebrow, and his mouth deviated towards the left. The patient was diagnosed with Bell's palsy associated with blepharospasm and discharged home on prednisone and famciclovir. By the eighth week he was back to baseline with no sequelae.

Conclusion: Although very rare, physicians should be aware of the existence of Bell's palsy associated with blepharospasm, as it may be under-reported.