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Severe hyponatremia and bilateral sequential facial palsy: A case report
Facial palsy (FP) is a known consequence of head trauma, manifesting either immediately at the time of injury or with delayed onset, typically occurring 2 days or more post-trauma. Unilateral FP is the more common presentation and is often attributed to partial or complete transection of facial nerv...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493881/ https://www.ncbi.nlm.nih.gov/pubmed/37701361 http://dx.doi.org/10.1016/j.radcr.2023.08.060 |
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author | Yazbeck, Mohamad Msheik, Ali Berjaoui, Christin Dabboucy, Baraa Comair, Youssef |
author_facet | Yazbeck, Mohamad Msheik, Ali Berjaoui, Christin Dabboucy, Baraa Comair, Youssef |
author_sort | Yazbeck, Mohamad |
collection | PubMed |
description | Facial palsy (FP) is a known consequence of head trauma, manifesting either immediately at the time of injury or with delayed onset, typically occurring 2 days or more post-trauma. Unilateral FP is the more common presentation and is often attributed to partial or complete transection of facial nerves or delayed onset edema. Conversely, bilateral facial palsy is a rare occurrence, reported in only a small number of cases, accounting for approximately 3% of patients presenting with bilateral weakness. In this report, we present the case of a previously healthy 28-year-old female who suffered a closed head injury during the Beirut Port Blast. Four days following the incident, the patient exhibited right-sided peripheral FP, which was consistent with a right temporal bone fracture. Subsequently, on the fifth day, the right-sided FP worsened, accompanied by the development of new FP on the left side, characterized by sparing of the frontal region, indicating a central origin for the left-sided FP. Laboratory investigations revealed severe hypovolemic hyponatremia with a sodium level of 105 mmol/L. As isotonic saline fluid replacement was initiated, there was progressive improvement in the left-sided FP. The right-sided palsy also resolved gradually with the implementation of facial rehabilitation therapy. It is important to note that severe head trauma, particularly with a concussive injury, can lead to facial paralysis through various mechanisms. Furthermore, severe hyponatremia should be considered a potential cause of central facial palsy, particularly in the presence of bilateral facial involvement. A thorough evaluation is encompassing assessment of palsy patterns, comprehensive imaging studies, and metabolic investigations is crucial for accurate diagnosis and timely intervention, resulting in successful treatment. |
format | Online Article Text |
id | pubmed-10493881 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-104938812023-09-12 Severe hyponatremia and bilateral sequential facial palsy: A case report Yazbeck, Mohamad Msheik, Ali Berjaoui, Christin Dabboucy, Baraa Comair, Youssef Radiol Case Rep Case Report Facial palsy (FP) is a known consequence of head trauma, manifesting either immediately at the time of injury or with delayed onset, typically occurring 2 days or more post-trauma. Unilateral FP is the more common presentation and is often attributed to partial or complete transection of facial nerves or delayed onset edema. Conversely, bilateral facial palsy is a rare occurrence, reported in only a small number of cases, accounting for approximately 3% of patients presenting with bilateral weakness. In this report, we present the case of a previously healthy 28-year-old female who suffered a closed head injury during the Beirut Port Blast. Four days following the incident, the patient exhibited right-sided peripheral FP, which was consistent with a right temporal bone fracture. Subsequently, on the fifth day, the right-sided FP worsened, accompanied by the development of new FP on the left side, characterized by sparing of the frontal region, indicating a central origin for the left-sided FP. Laboratory investigations revealed severe hypovolemic hyponatremia with a sodium level of 105 mmol/L. As isotonic saline fluid replacement was initiated, there was progressive improvement in the left-sided FP. The right-sided palsy also resolved gradually with the implementation of facial rehabilitation therapy. It is important to note that severe head trauma, particularly with a concussive injury, can lead to facial paralysis through various mechanisms. Furthermore, severe hyponatremia should be considered a potential cause of central facial palsy, particularly in the presence of bilateral facial involvement. A thorough evaluation is encompassing assessment of palsy patterns, comprehensive imaging studies, and metabolic investigations is crucial for accurate diagnosis and timely intervention, resulting in successful treatment. Elsevier 2023-09-05 /pmc/articles/PMC10493881/ /pubmed/37701361 http://dx.doi.org/10.1016/j.radcr.2023.08.060 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Yazbeck, Mohamad Msheik, Ali Berjaoui, Christin Dabboucy, Baraa Comair, Youssef Severe hyponatremia and bilateral sequential facial palsy: A case report |
title | Severe hyponatremia and bilateral sequential facial palsy: A case report |
title_full | Severe hyponatremia and bilateral sequential facial palsy: A case report |
title_fullStr | Severe hyponatremia and bilateral sequential facial palsy: A case report |
title_full_unstemmed | Severe hyponatremia and bilateral sequential facial palsy: A case report |
title_short | Severe hyponatremia and bilateral sequential facial palsy: A case report |
title_sort | severe hyponatremia and bilateral sequential facial palsy: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10493881/ https://www.ncbi.nlm.nih.gov/pubmed/37701361 http://dx.doi.org/10.1016/j.radcr.2023.08.060 |
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