Cranio : the journal of craniomandibular practice · 2025
Yawning-induced alternobaric facial palsy in a healthy young adult: A case report and review of the pathophysiology.
СтатьяКлинический случайОбзорНазвание и аннотация: Перевод в очереди
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Cammalleri Marcello, Zatta Esmeralda, Sala Gabriele, Fusetti Stefano, Salmini Sturli Arianna, Favero Vittorio
Аннотация
BACKGROUND: Alternobaric facial palsy (AFP) is a rare peripheral facial nerve palsy resulting from transient neurapraxia when sudden ambient-pressure changes disrupt middle-ear equilibrium. Common precipitants include scuba diving, air travel, and altitude. AFP triggered by routine activities is exceedingly uncommon.
CASE REPORT: A healthy 27 year old man developed acute right facial paresis after a prolonged yawn, while in the car. He reported ear fullness, cheek and tongue numbness, and inability to close the right eye, without other neurological sympthoms. Examination revealed a right peripheral facial palsy (House - Brackmann Grade IV), positive Bell's sign, and otherwise normal findings. CT and MRI of the brain and temporal bones showed no lesions. Other causes were ruled-out. Given the abrupt onset, absence of structural pathology, exclusion of other etiologies, AFP was diagnosed.
MANAGEMENT AND OUTCOME: Prednisone (50 mg, tapered over 3 weeks), eye care, and close follow-up led to full recovery within three weeks. No recurrence occurred at 3, 6, or 12 months.
CONCLUSIONS: This case highlights an atypical AFP trigger - a simple yawn - and underscores the importance of considering alternobaric mechanisms in acute peripheral facial palsy, even in everyday settings.
CASE REPORT: A healthy 27 year old man developed acute right facial paresis after a prolonged yawn, while in the car. He reported ear fullness, cheek and tongue numbness, and inability to close the right eye, without other neurological sympthoms. Examination revealed a right peripheral facial palsy (House - Brackmann Grade IV), positive Bell's sign, and otherwise normal findings. CT and MRI of the brain and temporal bones showed no lesions. Other causes were ruled-out. Given the abrupt onset, absence of structural pathology, exclusion of other etiologies, AFP was diagnosed.
MANAGEMENT AND OUTCOME: Prednisone (50 mg, tapered over 3 weeks), eye care, and close follow-up led to full recovery within three weeks. No recurrence occurred at 3, 6, or 12 months.
CONCLUSIONS: This case highlights an atypical AFP trigger - a simple yawn - and underscores the importance of considering alternobaric mechanisms in acute peripheral facial palsy, even in everyday settings.