Bell's palsy right side

Case contributed by A.Prof Frank Gaillard

Presentation

Bell's palsy 6 months ago, poor recovery.

Patient Data

Age: 45 years
Gender: Male
MRI

Asymmetric enhancement of the facial nerve genicular ganglion as demonstrated, with the right side demonstrating much greater enhancement than the left on the axial fat-saturated postcontrast T1 sequences. This asymmetry is much less marked on the thin 1 mm scan (not shown), indicating that at least part of the asymmetry is due to slice position. Otherwise the facial nerves appear normal bilaterally, and no brainstem lesion or cisternal lesion can be identified. Remainder the brain is unremarkable in appearance.

Conclusion: Probable minor asymmetry of enhancement in the region of the right geniculate ganglion, supporting the diagnosis of prior Bell's palsy. No central abnormality identified as an alternative explanation.

Case Discussion

Imaging of Bell's palsy is difficult and is in most ways more to exclude another cause for facial nerve palsy. 

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Case information

rID: 37995
Case created: 30th Jun 2015
Last edited: 14th Jul 2016
Inclusion in quiz mode: Excluded

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