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Bilateral facial swelling and Facial nerve palsy
  1. Rahul Pankhania,
  2. David Walker
  1. ENT Department, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
  1. Correspondence to Mr Rahul Pankhania, Royal Surrey County Hospital NHS Foundation Trust, Guildford GU2, UK; rahul.pankhania{at}

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Clinical Introduction

A 53-year-old man presented to the accident and emergency department with sudden onset left-sided facial nerve palsy and a 4-day history of progressive bilateral facial swelling. There is no history of any previous medical conditions, trauma or recent travel.

What is the most likely Diagnosis seen in figures 1 and 2?

  1. Bell’s Palsy.

  2. Stroke.

  3. Vasculitis.

  4. Parotid abscess.

For question see page 02

Figure 1

Patient presentation with bilateral facial swellings and facial nerve palsy.

Figure 2

Clinical findings when …

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  • Contributors DW is supervisor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.