Routine Dental Procedure Induced Hemifacial Paralysis—Case Report

Hemifacial paralysis, characterized by unilateral facial weakness, poses diagnostic challenges due to its potential overlap with various conditions. This case report explores the differential diagnosis of hemifacial paralysis and distinguishing between underlying causes. Facial paralysis as a complication from routine dental procedures is rare but significant. This case report details the incidence of unilateral facial paralysis following a right-sided posterior superior alveolar nerve block during the restoration of tooth #1 in a 51-year-old male. The patient experienced immediate numbness and facial asymmetry, persisting over four weeks despite initial reassurance from the dentist. Differential diagnoses considered included Bell’s palsy, stroke, Ramsay Hunt Syndrome, space-occupying lesions, Lyme disease, and nerve injury. Comprehensive testing ruled out these conditions, and Bell’s palsy was suspected. Treatment with methylprednisolone led to significant improvement, with complete recovery noted within two weeks. This case highlights the importance of timely diagnosis and treatment of facial paralysis, emphasizing the potential benefits of early steroid intervention even when the exact cause is uncertain.