A Case of Complete Recovery From Recurrent Bell’s Palsy After Peripheral Blood Stem Cell Transplantation

Abstrak

Background : Recurrent Bell’s palsy is a rare condition that can affect the
ipsilateral or contralateral to the affected side of the primary attack. There
is still no consensus on treatment guidelines for recurrent Bell’s palsy.
Therefore, we report a case of idiopathic recurrent contralateral facial
palsy treated with autologous peripheral blood stem cell (PBSC)
transplantation.
Case Presentation : A 72-year-old man presented with the sudden onset of
right facial weakness, which was contralateral to the affected side of the
first episode of facial palsy. The weakness had progressed with difficulty in
closing the right eye, drooling the water from the right side of the mouth,
and chewing impairment which was consistent with House Brackmann
grade IV or moderately severe facial nerve grading system. He had
exposure to cold stimulation, and a history of hypertension. He was given
G-CSF 10 ug/kg/day for 5 days to mobilize stem cells, followed by
apheresis on the 5th day. He did not receive acupuncture treatment. He
had a complete recovery in 3 weeks with House Brackmann grade I or
normal function of facial nerve.
Conclusion : Peripheral blood stem cell transplantation had a beneficial
effect on the complete recovery of this recurrent Bell’s palsy and provides
a treatment strategy in patients with unilateral facial palsy.
Keywords : Recurrent Bell’s palsy, idiopathic, peripheral blood stem cell
transplantatio