Psychiatry and Clinical Psychopharmacology

A rare presentation of psychogenic facial palsy

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S238-S238
Keywords : conversion, facial palsy
Read: 1839 Published: 17 February 2021

Conversion disorder is a condition, which the symptom and deficits affect the motor and/or sensorial functions. It usually mimics another organic disease but evaluated as a psychological factor- related condition on having stressors or conşicts before the disease onset. The conversion symptoms do not correspond to known anatomic ways and physiological mechanisms; instead, it is connected to how the patient conceptualizes the condition. In this case, presentation, we aimed to discuss an atypical psychogenic facial palsy case, which does not meet the classical peripheral or central facial nerve paralysis in the light of literature. A 25-year-old female presented with 4 weeks history of the loss of facial expression and the disfigurement. She did not have any diseases in her medical history, but she had taken many medications from different neurology clinics for facial palsy that did not shown recovery. The clinical examination revealed that loss of motor function at rest and whilst smiling in lower half left side of her face (infraorbital) and contralateral upper half (supraorbital). The laboratory and radiological examinations (CBC, MRI, Parotid gland USG, Stapes reşex and EMG) revealed that there was no organic pathology in the Otolaryngology clinic. Therefore, the patient consulted to the Psychiatry clinic regarding psychogenic facial palsy. She was prescribed escitalopram 10 mg and risperidone 1 mg daily. During her first control visit at 3 weeks, she reported an asymptomatic period of approximately 2 weeks. Clinical examination revealed that facial symmetry at rest and whilst smiling and complete recovery. In follow-up psychiatric interviews showed that she has family stress factors and husband and wife problems. The medication and interviews were continued for up to 6 months. Due to cessation of active psychiatric complaints and recurrence in atypical facial paralysis symptoms, medical treatment and psychiatric interviews were stopped. In this case, although symptoms mimicking the neurological symptoms dominated the situation, no organic etiology was detected. The patients with conversion disorder usually apply to non-psychiatric clinics. In addition, when a patient presents with facial palsy without laboratory and electro-physiological events, a psychogenic facial palsy should be born in mind with respect to differential diagnosis.

EISSN 2475-0581