A Rare Case of Heerfordt’s Syndrome with Bilateral Facial Palsy

Abstract

Sarcoidosis is a multi systemic granulomatous disorder involving all the organs of the body. Heerfordt’s syndrome is an acute and rare presentation of sarcoidosis. It presents with fever, uveitis and bilateral parotid swelling with unilateral or bilateral facial palsy. It is seen in 0.3 % of cases of sarcoidosis. Typical presentation of Heerfordt’s syndrome is rare. Facial palsy is seen in 25–50 % of Heerfordt’s syndrome. Bilateral facial palsy is very rare contributing to only 0.3–2 % of all cases of facial nerve palsies. The diagnosis is very difficult as the facial features are less obvious compared to unilateral palsy. In this case report, we have presented a rare case of Heerfordt’s syndrome with bilateral facial palsy which was misdiagnosed as mumps. This case highlights the importance of including Heerfordt’s syndrome in evaluating the causes of facial palsy. Bilateral facial palsy unlike unilateral is less obvious. Hence a detailed history, thorough clinical examination and relevant investigations will aid in arriving at diagnosis and better management of the patient.