# Contrast-Enhanced MRI Is Useful for Prognostic Prediction on Idiopathic Bilateral Simultaneous Facial Nerve Palsy: A Case Report and Literature Review

## TL;DR

Contrast-enhanced MRI helps predict the prognosis of rare bilateral facial nerve palsy by showing nerve damage severity.

## Contribution

The paper demonstrates contrast-enhanced MRI's utility in predicting outcomes for idiopathic bilateral facial nerve palsy.

## Key findings

- Contrast-enhanced MRI showed higher signal intensity on the left facial nerve compared to the right.
- Facial nerve decompression on the left led to improvement after eight months, while the right improved in two months.
- MRI provided valuable information for evaluating and predicting the prognosis of bilateral facial nerve palsy.

## Abstract

Idiopathic bilateral facial nerve palsy is a rare condition and presents a diagnostic and prognostic challenge. Specifically, when bilateral nerves are damaged, it is difficult to predict the prognosis. We showcase the usefulness of contrast-enhanced magnetic resonance imaging (MRI) by providing information about localization and severity of degeneration of facial nerve. A 70-year-old Japanese man presented with bilateral simultaneous facial nerve palsy of House-Brackmann Grade VI on both sides. Contrast-enhanced MRI revealed bilateral intensity enhancement of intratemporal facial nerves. The signal intensity was higher on the left side than on the right side. Facial nerve decompression was performed on the left side. The left facial nerve palsy was finally improved eight months after the onset, while the right side was improved just under two months after the onset. Contrast-enhanced MRI for facial nerve palsy can provide valuable information for the evaluation of damaged facial nerves. In our patient’s case, it was useful as a prognostic predictor of bilateral facial nerve palsy.