Facial Nerve Palsy as Frequent Presentation in Patient with Rhinocerebral Mucormycosis

N. Aloosi, Suha

	Facial Nerve Palsy as Frequent Presentation in Patient with Rhinocerebral Mucormycosis
Journal of Oral and Dental Research
Article 1, Volume 5, Issue 1, 2018, Pages 55-69
Author
Suha N. Aloosi
Abstract
Background Early recognition of rhinocerebral mucormycosis is critical for initiation of treatment. The clinical presentation of the disease shares the same clinical picture with many other diseases, which might lead to misdiagnosis. Features of neural involvement, such as facial nerve palsy, headache and mental state alteration, are important in presentation of mucormycosis; however, they are commonly overlooked. Objectives This study was done to highlight facial nerve palsy as an early feature of Rhinocerebral mucormycosis, which may improve the quality of the clinical recognition and encourage further related investigation and managements steps. Materials and Methods Thirteen patients with variable signs and symptoms of Rhinocerebral Mucormycosis were diagnosed and treated in The Maxillofacial Unit in Sulaimani Teaching Hospital, Kurdistan / Iraq. Their clinical and laboratory data were retrospectively analyzed. Results Neurological features of facial nerve palsy were reported in a signifcant percent of the included patients (61.5%) p=0.001. It was signifcantly associated with misdiagnosis as Cerebro-Vascular Accident (CVA) (P=0.047) and with bad prognosis of the disease (p=0.042). Conclusion Facial nerve weakness is a signifcant sign in presentation of mucormycosis. A signifcant proportion of such patients could be misdiagnosed as CVA patients, with subsequent delay in treatment. Increasing the suspicion index for mucormycosis in diabetic patients presenting with facial palsy helps in reaching an accurate and early diagnosis.
Keywords
Rhinocerebral Mucormycosis; facial nerve

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