Alternating Bell's palsy associated with diabetes mellitus. A report of four cases.

Four diabetic patients are presented with alternating facial palsy. The term alternating is meant to imply facial nerve paralysis, the onset of which occurs at different points in time on both sides of the face. Clinical findings are presented and a short review of the literature is summarized. The authors conclude that alternating facial palsy is often associated with diabetes mellitus. Alternating facial palsy is an infrequent finding. This is in marked contrast to the unilateral form. Approximately every 13 minutes someone in the United States incurs idiopathic facial paralysis or Bell's palsy (20 persons per 100,000 per year). It is apparent that the majority of unilateral facial palsies fall into the idiopathic category. The alternating form of facial paralysis, however, appears to be an unusual finding in a symptom complex of several diseases which will be discussed. It is the diagnostic significance of this alternating facial paralysis and its occasional association with diabetes mellitus that prompts this report.