# Facial Diplegia in Bell's Palsy: A Diagnostic Conundrum

## TL;DR

A rare case of Bell's palsy causing both-sided facial paralysis is reported, highlighting the need to consider this diagnosis despite unusual symptoms.

## Contribution

Reports a rare case of facial diplegia in Bell's palsy with atypical features and successful treatment.

## Key findings

- Facial diplegia was diagnosed as Bell's palsy despite MRI and other findings.
- The patient fully recovered after treatment with antivirals and steroids.

## Abstract

Bell's palsy typically causes one-sided facial paralysis, while bilateral involvement (facial diplegia) is uncommon. The following case is presented of a middle-aged woman who developed simultaneous facial diplegia diagnosed as Bell's palsy. Further complicating the diagnostic picture were MRI findings of temporal lobe abnormalities, recent Botox injection, and unspecified finger nodules. Diagnostic tests excluded other causes of bilateral facial paralysis. The patient was treated with antivirals and steroids and had a full recovery. This case shows the rare occurrence of facial diplegia in Bell's palsy, emphasizing the importance of considering this diagnosis, even in atypical presentations.