OTHER ETIOLOGIES OF FACIAL NEUROPATHY

Lyme disease is a relatively common infectious cause of an acute unilateral or bilateral facial neuropathy. Symptoms typically include systemic symptoms (e.g., arthralgia, fever, rash), as well as other neurologic symptoms (e.g., headache, radiculitis, encephalopathy). Herpes zoster infection within the external auditory canal (Ramsay-Hunt syndrome), may cause facial paralysis that may precede the appearance of typical herpetic vesicles in the auditory canal. Extension of otitis media may rarely inflame and damage the facial nerve where it travels through the petrous bone. Leprosy may lead to bilateral facial nerve lesions. Unilateral or bilateral facial neuropathy is a common neurologic manifestation of sarcoidosis. Bilateral facial weakness is common in Guillain-Barré syndrome (acute inflammatory demyelinating polyradiculopathy).

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