Alternating facial paralysis in a girl with hypertension. Case report

Bell's palsy is the most common cause of acquried unilateral facial nerve palsy in childhood. Although the diagnosis depends on the exclusion of less common causes such as infectious, traumatic, malignancy associated and hypertension associated etiologies, pediatricians tend to diagnose idiopatic Bell's palsy whenever a child admits with acquired facial weakness. In this report, we present an eight year old girl, presenting with reccurent and alternant facial palsy as the first symptom of systemic hypertension. She had underwent steroid treatment without measuring blood pressure that could worsen hypertension. Clinicians should be aware of this association and not neglect to measure the blood pressure before considering steroid therapy for Bell's palsy. In addition, the less common causes of acquired facial palsy should be kept in mind, especially when reccurent and alternant courses occur