Teaching NeuroImage: Peripheral Facial Palsy as the Initial Manifestation of Chronic Invasive Fungal Rhinosinusitis | Neurology
A 59-year-old man with diabetes presented with peripheral facial palsy of 3-month duration without improvement despite measures to control blood glucose. Endoscopy suggested inflammatory necrosis within the sinuses, leading to a diagnosis of chronic invasive fungal rhinosinusitis (Figure 1). MRI revealed disease within the pterygopalatine fossa, infratemporal fossa, and vidian and maxillary nerves. Lacrimal gland secretion was reduced in the right eye while 1,3-β-glucan level and chest CT were unremarkable
