Magnetic resonance imaging findings in bilateral Bell's palsy

Bell's palsy (idiopathic facial paralysis) is the most common cause of unil ateral peripheral facial neuropathy. Bilateral involvement occurs in less t han 10% of cases. The authors describe a 20-year-old man with bilateral idi opathic facial weakness. Brain magnetic resonance imaging (MRI) showed abno rmal bilateral enhancement of the proximal intracanalicular segments of VII /VIII nerve complexes. The enhancement was most prominent in the leptomenin geal regions. There was no facial nerve swelling. Three months later he had improving residual bifacial weakness. To the authors' knowledge, this is t he first report of abnormal MRI findings in bilateral Bell's palsy.