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A Rare Case of Heerfordt’s Syndrome with Bilateral Facial Palsy

  • Jamunarani SrirangaramasamyEmail author
  • Shakthesh Kathirvelu
Clinical Report
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Abstract

Sarcoidosis is a multi systemic granulomatous disorder involving all the organs of the body. Heerfordt’s syndrome is an acute and rare presentation of sarcoidosis. It presents with fever, uveitis and bilateral parotid swelling with unilateral or bilateral facial palsy. It is seen in 0.3 % of cases of sarcoidosis. Typical presentation of Heerfordt’s syndrome is rare. Facial palsy is seen in 25–50 % of Heerfordt’s syndrome. Bilateral facial palsy is very rare contributing to only 0.3–2 % of all cases of facial nerve palsies. The diagnosis is very difficult as the facial features are less obvious compared to unilateral palsy. In this case report, we have presented a rare case of Heerfordt’s syndrome with bilateral facial palsy which was misdiagnosed as mumps. This case highlights the importance of including Heerfordt’s syndrome in evaluating the causes of facial palsy. Bilateral facial palsy unlike unilateral is less obvious. Hence a detailed history, thorough clinical examination and relevant investigations will aid in arriving at diagnosis and better management of the patient.

Keywords

Bilateral facial palsy Heerfordt’s syndrome Neurosarcoidosis Sarcoidosis 

References

  1. 1.
    Chappity P, Kumar R, Sahoo AK (2015) Heerfordt’s syndrome presenting with recurrent facial nerve palsy: case report and 10-year literature review. Sultan Qaboos Univ Med J 15:129Google Scholar
  2. 2.
    Sharma SK, Soneja M, Sharma A, Sharma MC, Hari S (2012) Rare manifestations of sarcoidosis in modern era of new diagnostic tools. Indian J Med Res 135:621–629CrossRefGoogle Scholar
  3. 3.
    Joseph FG, Scolding NJ (2009) Neurosarcoidosis: a study of 30 new cases. J Neurol Neurosurg Psychiatry 80:297–304. doi: 10.1136/jnnp.2008.151977 CrossRefPubMedGoogle Scholar
  4. 4.
    Heerfordt CF (1909) Über eine “febris uveo-parotidea subchronica” an der glandula parotis und der uvea des auges lokalisiert und häufug mit paresen cerebrospinaler nerven kompliziert. Albrecht von Grafes Archiv für Ophthalmologie 70:254–273CrossRefGoogle Scholar
  5. 5.
    Pothiawala S, Lateef F (2012) Bilateral facial nerve palsy: a diagnostic dilemma. Case Rep Emerg Med 2012:458371PubMedPubMedCentralGoogle Scholar
  6. 6.
    Kato K, Kato Y, Tanaka Y, Miyazaki M, Nakaseko Y, Uji Y (2011) Case of Heerfordt’s syndrome presenting polyneuropathy. Nihon Ganka Gakkai Zasshi 115:460–464PubMedGoogle Scholar
  7. 7.
    Koo V, Lioe T, Spence R (2006) Fine needle aspiration cytology (FNAC) in the diagnosis of granulomatous lymphadenitis. Ulster Med J 75(1):59–64PubMedPubMedCentralGoogle Scholar
  8. 8.
    Iannuzzi MC, Rybicki BA, Teirstein AS (2007) Sarcoidosis. N Engl J Med 357:2153–2165CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2016

Authors and Affiliations

  • Jamunarani Srirangaramasamy
    • 1
    • 3
    Email author
  • Shakthesh Kathirvelu
    • 2
  1. 1.Department of PathologyTagore Medical College and HospitalChennaiIndia
  2. 2.Hopkins ENTChennaiIndia
  3. 3.ChennaiIndia

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