Recurrent facial nerve paralysis is uncommon and few studies have evaluated this unique population. ![]() Facial nerve decompression via a middle cranial fossa approach was performed in three (5.7%) cases without subsequent episodes of paralysis. Diagnostic evaluation confirmed Melkersson-Rosenthal syndrome in four (7.5%) cases, neurosarcoidosis in two (3.7%), traumatic neuroma in one (1.9%), Ramsay Hunt syndrome in one (1.9%), granulomatosis with polyangiitis in one (1.9%), and neoplastic causes in three (5.7%) cases ultimately, 77.4% (41) of cases were deemed idiopathic. The median nadir House-Brackmann score was 4, with a median recovery to House-Brackmann grade 1.5 over a mean recovery time of 61.8 days (range 1-420 d). The median number of paretic events for all patients was 3 (range 2-20). No cases of bilateral simultaneous facial nerve paralysis were observed. Twenty-two (41.5%) cases presented with ipsilateral recurrences only, while the remaining 31 patients (58.5%) had at least 1 episode of contralateral recurrent paralysis. Clinical presentation, laboratory and imaging findings, treatment and outcome for all cases of recurrent ipsilateral, recurrent contralateral, and bilateral simultaneous cases of facial paralysis are reviewed.Ä«etween 20, 53 patients were evaluated for recurrent facial nerve paralysis at the authors' institution. ![]() ![]() Retrospective review at a single tertiary academic center and systematic review of the literature. To examine the etiology, clinical course, and management of recurrent peripheral facial nerve paralysis.
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