13 year-old with abrupt onset of left facial weakness




           
T1 coronals post Gad                                                                                                


      
T1 coronals post Gad




T1 axial post Gad



Findings:

Enhancement of the left CN VII. Specifically the distal canalicular, the labyrinthine, the tympanic, and the mastoid segments enhance.

DDX:

Bell's palsy, atypical schwanomma



Diagnosis:

Bell's palsy


Discussion:

Thin-section contrast-enhanced MR scans are recommended for individuals with atypical presentation of facial paralysis. In the proper clinical setting, contrast-enhanced MR imaging may permit a positive radiographic diagnosis of Bell's palsy, which has previously been a diagnosis of exclusion.



Submitted by Anthony Giauque, MD, UW Neuroradiology Fellow

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