Outcome of a Multidimensional Physiotherapy Protocol in the Unique Case of a Bilateral Facial Palsy: Case Report

Authors

  • Neha Biyala BPT, Physiotherapist, JOSH Clinic 28, 1, Anjanapura Main Rd, Anjanapura, Bengaluru,  Karnataka
  • Joshua Samuel Rajkumar MPT, Master of Science (Psychology), Physiotherapist JOSH Clinic 28, 1, Anjanapura Main Rd, Anjanapura, Bengaluru, Karnataka
  • Shagufta Kausar BPT, Physiotherapist, JOSH Clinic 28, 1, Anjanapura Main Rd, Anjanapura Bengaluru, Karnataka

DOI:

https://doi.org/10.37506/v3cvd179

Keywords:

bilateral facial palsy , physiotherapy, rehabilitation, facial disability index, facial muscle function, psychosocial impact, multidimensional approach

Abstract

Background: Bilateral facial palsy is a rare disorder that significantly affects facial expressiveness, emotional well-being 
and social interactions. Effective rehabilitation approaches play a key role in enhancing functional and psychological 
outcomes of patients.
Case Report: This study focuses on a 30-year-old woman with bilateral facial palsy of unknown cause. After comprehensive 
diagnostic evaluations excluded common causes, the patient began an 8-week multidisciplinary physiotherapy program 
that emphasized motor function, emotional expressiveness, and social participation. Complementary therapy, functional 
exercise, and patient education were included in the plan.
Result: Notable improvements were observed in the patient’s social confidence, speech clarity, and facial motor function. 
The physical function subscale of the Facial Disability Index (FDI) scores increased from 25/100 to 90/100, whereas the 
social function subscale scores increased from 55/100 to 100/100. At follow-up, progress was maintained.
Conclusion: Patients with bilateral facial palsy can benefit from a multidisciplinary physiotherapy strategy that combines 
psychological and physical rehabilitation to improve their quality of life and recovery rate. It is advised that more research 
be done on the differences in therapy response based on age and gender..

Downloads

Download data is not yet available.

Author Biographies

  • Neha Biyala, BPT, Physiotherapist, JOSH Clinic 28, 1, Anjanapura Main Rd, Anjanapura, Bengaluru,  Karnataka

    BPT, Physiotherapist, JOSH Clinic 28, 1, Anjanapura Main Rd, Anjanapura, Bengaluru, 
    Karnataka

  • Joshua Samuel Rajkumar, MPT, Master of Science (Psychology), Physiotherapist JOSH Clinic 28, 1, Anjanapura Main Rd, Anjanapura, Bengaluru, Karnataka

    MPT, Master of Science (Psychology), Physiotherapist JOSH Clinic 28, 1, Anjanapura Main Rd, Anjanapura, Bengaluru, Karnataka

  • Shagufta Kausar, BPT, Physiotherapist, JOSH Clinic 28, 1, Anjanapura Main Rd, Anjanapura Bengaluru, Karnataka

    BPT, Physiotherapist, JOSH Clinic 28,  1, Anjanapura Main Rd, Anjanapura Bengaluru, Karnataka

References

Kumar M, Acharya S, Vineetha R, Pai KM. Bilateral

Bell’s palsy in a young female: a rare case report.

Medicine and Pharmacy Reports. 2021 Jan 29;94(1):118.

Jones D. Bell’s palsy: an overview. InnovAiT. 2012.

VanSwearingen JM, Cohn JF, Bajaj-Luthra A.

Specific impairment of smiling increases the severity

of depressive symptoms in patients with facial

neuromuscular disorders. Aesthetic plastic surgery.

Nov;23:416-23.

Yang A, Dalal V. Bilateral facial palsy: a clinical

approach. Cureus. 2021 Apr 25;13(4).

Price, T., & Fife, D. G. (2002). Bilateral simultaneous

facial nerve palsy. The Journal of Laryngology &

Otology, 116(1), 46-48.

Gaudin RA, Jowett N, Banks CA, Knox CJ,

Hadlock TA. Bilateral facial paralysis: a 13-year

experience. Plastic and reconstructive surgery.

Oct 1;138(4):879-87.

Kim YH, Choi IJ, Kim HM, Ban JH, Cho CH, Ahn

JH. Bilateral simultaneous facial nerve palsy: clinical

analysis in seven cases. Otology & Neurotology. 2008

Apr 1;29(3):397-400.

Jha G, Azhar S, Kuttuva S, Elahi S, Baseer A. Bilateral

facial palsy: a case study of an exceedingly rare and

difficult diagnosis. Cureus. 2021 Oct 19;13(10).

Jung J, Park DC, Jung SY, Park MJ, Kim SH, Yeo SG.

Bilateral facial palsy. Acta Oto-Laryngologica. 2019

Oct 3;139(10):934-8.

Hilsinger Jr RL, Adour KK, Doty HE. Idiopathic

facial paralysis, pregnancy, and the menstrual cycle.

Annals of Otology, Rhinology & Laryngology. 1975

Jul;84(4):433-42.

Li J, Goldberg G, Munin MC, Wagner A, Zafonte R.

Post-traumatic bilateral facial palsy: a case report

and literature review. Brain Injury. 2004 Mar 1;18(3):

-20.

Prakash V, Hariohm K, Vijayakumar P, Thangjam

Bindiya D. Functional training in the management

of chronic facial paralysis. Physical Therapy. 2012

Apr 1;92(4):605-13.

Elliott JM. Physiotherapy treatment of Bell’s Palsy: a

case report. New Zealand Journal of Physiotherpy.

Nov;34(3):167-71.

May M, Schaitkin BM. History of facial nerve surgery.

Facial plastic surgery. 2000;16(04):301-8.

de Swart BJ, Verheij JC, Beurskens CH. Problems

with eating and drinking in patients with unilateral

peripheral facial paralysis. Dysphagia.

Oct;18:267-73.

Fink B, Penton-Voak I. Evolutionary psychology

of

attractiveness. Current Directions in

Psychological Science. 2002 Oct;11(5):154-8.

Györi E, Przestrzelski C, Pona I, Hagmann M, Rath

T, Radtke C, Tzou CH. Quality of life and functional

assessment of facial palsy patients: a questionnaire

study. International Journal of Surgery. 2018 Jul

;55:92-7.

Saadi R, Shokri T, Schaefer E, Hollenbeak C, Lighthall

JG. Depression rates after facial paralysis. Annals of

plastic surgery. 2019 Aug 1;83(2):190-4.

Coulson SE, O’Dwyer NJ, Adams RD, Croxson GR.

Expression of emotion and quality of life after facial

nerve paralysis. Otology & neurotology. 2004 Nov

;25(6):1014-9.

Tuncay F, Borman P, Taser B, Ünlü I, Samim E.

Role of electrical stimulation added to conventional

therapy in patients with idiopathic facial (Bell)

palsy. American journal of physical medicine &

rehabilitation. 2015 Mar 1;94(3):222-8.

Alakram P, Puckree T. Effects of electrical stimulation

on house-brackmann scores in early bells palsy.

Physiotherapy theory and practice. 2010 Jan

;26(3):160-6.

Özden F, Tümtürk İ, Sarı Z. Psychometric properties of

the Facial Disability Index in patients with facial palsy:

a systematic review and meta-analysis. Neurological

Sciences. 2022 Jul;43(7):4157-65

Downloads

Published

2026-01-07

How to Cite

Outcome of a Multidimensional Physiotherapy Protocol in the Unique Case of a Bilateral Facial Palsy: Case Report. (2026). Indian Journal of Physiotherapy and Occupational Therapy - An International Journal, 20(1), 1-6. https://doi.org/10.37506/v3cvd179