Bilateral Facial Palsy as the Onset of Neurosarcoidosis: A Case Report and a Revision of Literature

Unilateral facial nerve palsy (FNP) is one of the most common cranial mononeuropathies. Among rare etiologies, neurosarcoidosis (NS) can cause bilateral involvement (both recurring and simultaneous) only in 15% to 25% cases. The rarity this systemic disease its clinical heterogeneity, due granulomatous inflammation that may affect many anatomic substrates, frequently make diagnosis a real challenge for clinician. Based on laboratory instrumental tests, careful diagnostic algorithm must be adopted avoid misdiagnosis delay treatment. We present 52-year-old woman with an acute onset unilateral right FNP, rapidly developing contralateral (simultaneous FNP). Lung findings pointed towards disease, then lymph node biopsy confirmed NS. Corticosteroid therapy was started. After three years follow-up, patient still remission low prednisone dose. discuss differential focusing presentation, diagnosis, treatment have performed literature revision, confirming outside Heerfordt syndrome, sometimes represent neurological manifestation NS onset.