# Bell Palsy Mimics: Lessons from Four Malpractice Cases

## TL;DR

This paper discusses four malpractice cases involving misdiagnosis of Bell palsy and highlights the clinical and legal risks of incorrect diagnosis.

## Contribution

The paper provides real-world examples of legal consequences from misdiagnosing Bell palsy and emphasizes the importance of proper diagnosis and documentation.

## Key findings

- Misdiagnosis of Bell palsy can lead to significant legal consequences, including large settlements and jury verdicts against physicians.
- Proper diagnosis requires understanding the disease's pathophysiology and thorough documentation of clinical findings.
- Failure to obtain informed consent and provide appropriate discharge instructions were common allegations in the cases.

## Abstract

Bell palsy, an idiopathic dysfunction of the seventh cranial nerve, is the leading cause of unilateral facial paralysis, although other more serious entities such as stroke, infection, and tumor may present similarly, leading to both medical and legal risks in cases of misdiagnosis.

We present four malpractice cases revolving around misdiagnosis of Bell palsy. These cases alleged failure to diagnose, failure to obtain informed consent, and failure to provide appropriate discharge instructions. Outcomes ranged from a jury verdict in favor of the physician, to an out-of-court settlment for $400,000, to a jury verdict in favor of the patieint for over $3.1 million.

Bell palsy is the most common cause of unilateral facial paralysis. While the diagnosis can be made at the bedside without advanced testing, doing so requires a clear understanding of the pathophysiology of the disease, an appreciation for the role of advanced diagnostics, and thorough documentation of a supportive history and physical exam. Misdiagnosis or mismanagement confers both clinical and legal risks.