Answer:
Left Bell's Palsy.
Findings:
Relative enhancement of the left facial nerve involving the geniculate ganglion, labyrinthine and anterior tympanic segments is noted.
DiscussionThis patient clinically presented with Bell`s Palsy. Bell`s palsy was long considered idiopathic but recent evidnee suggests reactivation of herpes simplex virus with latent infection in geniculate ganglion. Contrast enhancement can also be seen in Ramsay Hunt Syndrome.However it is difficult to differentiate both based on enhancement pattern alone. The differentiation is based on clinical features Facial nerve edema may last longer and be more severe in Ramsay Huntsyndrome than in Bell’s palsy. The distal canalicular segment is less commonly involved in both these conditions , where any focally enhancing lesion is suspicious of Acoustic Neuroma.
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai
Left Bell's Palsy.
Findings:
Relative enhancement of the left facial nerve involving the geniculate ganglion, labyrinthine and anterior tympanic segments is noted.
DiscussionThis patient clinically presented with Bell`s Palsy. Bell`s palsy was long considered idiopathic but recent evidnee suggests reactivation of herpes simplex virus with latent infection in geniculate ganglion. Contrast enhancement can also be seen in Ramsay Hunt Syndrome.However it is difficult to differentiate both based on enhancement pattern alone. The differentiation is based on clinical features Facial nerve edema may last longer and be more severe in Ramsay Huntsyndrome than in Bell’s palsy. The distal canalicular segment is less commonly involved in both these conditions , where any focally enhancing lesion is suspicious of Acoustic Neuroma.
Contributed By:
Dr. Babu Peter MD, DNB
Associate Professor, Barnard Institute of Radiology, Chennai
Senior Consultant Radiologist, Aarthi Scans, Chennai