TITLE:
Post-Influenza Peripheral Facial Paralysis: A Case Report and Literature Review at the National Reference General Hospital of N’Djamena (Chad)
AUTHORS:
Adoum Hamad Zenal Abidine, Boubacar Soumaila, Madjirabé Christian, Mht Alkher Ousmane, Guelngar Othon Carlos, Alhadj Mht Moustapha, Adoum Hamat Kaltam, Adoum Hamat Alfaris, Tahir Aiba, Abdel-Madjid Zakaria Zakaria, Toure Kamadore
KEYWORDS:
Peripheral Facial Paralysis, Influenza, N’Djamena, HGRN
JOURNAL NAME:
Open Access Library Journal,
Vol.12 No.9,
September
17,
2025
ABSTRACT: Introduction: The facial nerve is the cranial nerve with the longest intra-canal bone path. This explains its great vulnerability during inflammatory processes affecting the petrous bone. The facial nerve is a mixed nerve with motor, sensitive, sensory and autonomic functions. The symptoms of its paralysis are therefore varied; they depend on the level of nerve damage. Case presentation: This is a 22-year-old patient who is a farmer. The patient presented four weeks later with fever, sore throat, cough, fatigue and myalgia. The proposed treatment was that of a simple malaria attack. The evolution was favorable. One week later, the patient presented facial asymmetry upon waking with the face deviated to the right side and incomplete closure of the left eye. There was no evidence of chronic rash, tick bites, or exposure to a toxin. The patient consulted an ophthalmologist who prescribed treatment of an unknown nature. One week after the onset of facial deviation, the course was unfavorable, marked by the inability to perform any facial expressions; the inability to close the right eyelid. Given these symptoms, the patient consulted our department for treatment. Discussion: Unilateral peripheral facial paralysis is a common anatomoclinical entity in hospitals. A few cases have been described in the literature. The largest series include 4 to 7 cases. Bilateral peripheral facial paralysis represents 0.3% - 2% of peripheral facial paralysis. It affects all age groups; the most affected interval concerns the age group between 11 and 58 years, although our patient is 22 years old. Unilateral peripheral facial paralysis has several etiologies. In most cases it is an idiopathic pathology. Other etiologies described are: infectious, mainly viral (Lyme disease; Herpes and HIV, etc.), hence the flu-like syndrome often described. Etiologies are also inflammatory (sarcoidosis), metabolic (diabetes), neoplastic and neurological. And post COVID-19 causes have been recently described. Stress and post-influenza infection are the most commonly found antecedents. In the clinical case described, the patient had a sore throat a few weeks before the onset of the first symptoms. The most objective way to assess the severity and recovery is electromyography. It assesses the intensity of the damage and recovery. Several electroneuromyograms must be performed. In sub-Saharan Africa, this examination remains difficult to access due to the sometimes limited technical facilities and its cost. Most authors agree that, in the face of idiopathic peripheral facial paralysis, treatment should be started with corticosteroids (prednisolone) and acyclovir. Physiotherapy also plays an important role. Conclusion: Bell’s peripheral facial palsy represents a diagnostic and therapeutic challenge for the practitioner in our context. In most cases it remains idiopathic.