Bilateral peripheral facial palsy secondary to Waldenstrِmʹs macroglobulinemia. A case report and literature review

A 59-year old woman who attended the emergency department because of a bilateral peripheral facial nerve palsy (FNP). Bilateral FNP is uncommon, an idiopathic cause is unlikely and consequently a comprehensive study is indicated. An IgM monoclonal gammopathy was detected on serum protein electrophoresis of our patient. Bone marrow biopsy showed the presence of lymphoplasmocytoid cells. On the basis of these findings the diagnosis of Waldenstrِmʹs macroglobulinemia (WM) was made. Secondary cranial nerve palsies are rarely seen in this condition. This report describes a case of bilateral FNP as initial presentation of a Waldenstrِmʹs macroglobulinemia and discuss treatment.