title: Bell's palsy as an early manifestation of acute lymphoblastic leukemia.
abstract: A 20-year-old man with the complaints of malaise, fever, and tooth gum bleeding presented at a hospital. He was found to have generalized lymphadenopathy, thrombocytopenia, and leukocytosis. Ensuing bone marrow biopsy led to a diagnosis of acute lymphoblastic leukemia (ALL). He also had a sense of "facial stretching" and difficulty during eating. After clinical examination, he was diagnosed with right-sided peripheral type facial nerve paralysis (Bell's palsy). The magnetic resonance imaging studies demonstrated bilateral facial nerve involvement, predominantly on the right side. The patient received steroid treatment and local facial radiotherapy for Bell's palsy. A concurrent facial exercise program was ordered. Seemingly a less significant diagnosis in a leukemia patient, we considered our case notable since an ALL patient presenting with Bell's palsy, especially at the very beginning of the disease, is not that common. The cases of relapsing ALL reported in the literature initially presenting with the same scenario further strengthen the significance.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Turkey.
authors.forename: L
authors.initials: L
authors.lastname: Özçakar
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hacettepe University Medical School, Turkey. lozcakar@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: Akıncı
authors.affiliation: Department of Physical Medicine and Rehabilitation, Fırat University Medical School, Elazığ, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Özgöçmen
authors.affiliation: Department of Internal Medicine, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Aksu
authors.affiliation: Department of Radiation Oncology, Hacettepe University Medical School, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Çetin
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D020330:Bell Palsy / Q000175:diagnosis / Q000209:etiology* / Q000532:radiotherapy; D005155:Facial Nerve Diseases / Q000532:radiotherapy; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013256:Steroids / Q000627:therapeutic use
chemical_list: D013256:Steroids