It sounds rare and I have to admit that I have not seen it often – but probably it is often overlooked in the busy ER. So here is one of the secondary facial palsy types that you should be able to recognize: the patient reports some swelling in the face (usually the upper lip) at least in the past, more often concomitant with the facial palsy. Search for the combination
- facial/lip swelling (recurrent)
- cheilitis granulomatosis (probably from incomplete recuperation from the swelling attacks)
- lingua plicata
- facial palsy.