Recurrent Attacks of Facial Nerve Palsy as the Presenting Sign of Leukemic Relapse

Objective To present an unusual case of recurrent facial palsy resulting from acute leukemic infiltration of the parotid gland. Study Design Case report. Methods An 11‐year‐old boy who had been treated for acute lymphoblastic leukemia (ALL) from 3 to 6 years of age presented with intermittent left f...

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Bibliographic Details
Published in:The Laryngoscope 2002-02, Vol.112 (2), p.235-237
Main Authors: Rhee, Dukhee, Myssiorek, David, Zahtz, Gerald, Diamond, Alan, Paley, Carol, Shende, Ashok
Format: Article
Language:English
Subjects:
Biological and medical sciences
Child
Diagnosis, Differential
Disease Progression
Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology
Facial nerve paralysis
Facial Paralysis - diagnosis
Follow-Up Studies
Hematologic and hematopoietic diseases
Humans
leukemia
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
Magnetic Resonance Imaging
Male
Medical sciences
Non tumoral diseases
Otorhinolaryngology. Stomatology
parotid gland
Parotid Gland - physiopathology
Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Recurrence
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Summary:Objective To present an unusual case of recurrent facial palsy resulting from acute leukemic infiltration of the parotid gland. Study Design Case report. Methods An 11‐year‐old boy who had been treated for acute lymphoblastic leukemia (ALL) from 3 to 6 years of age presented with intermittent left facial nerve palsy with concurrent ipsilateral parotid fullness. The initial findings at diagnosis and workup are presented, and the disease progression and resolution with therapy are documented. Results The patient had been off therapy when this finding developed. A workup for central and viral etiologies for the facial palsy was unrevealing. Biopsy of the parotid gland demonstrated a lymphoblastic leukemic infiltrate. The patient was placed on a chemotherapy protocol for relapsed leukemia, resulting in complete resolution of the facial palsy. Conclusion Isolated facial nerve dysfunction, albeit rare, has been documented as a sign of central nervous system involvement in leukemia, but until now this presentation has not been described in the setting of leukemic relapse presenting with acute infiltration of the parotid gland.
ISSN:0023-852X
1531-4995
DOI:10.1097/00005537-200202000-00007