PMC9486985_01
The patient's clinical course of bilateral facial nerve palsy.. 
(A, B) The shallowed left nasolabial fold was observed at rest on the 5th day after admission (A) and when grinning on the 6th day (B). (C-E) The shallowed bilateral nasolabial folds when grinning on the 8th (C), 18th (D) and 33rd (E) days after admission. (F) The improved nasolabial fold abnormalities when grinning 6 months after admission. (G-J) The forehead wrinkling, observed on the 8th (G), 24th (H) and 33rd (I) days after admission, improved 6 months after admission (J)
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Physical examination revealed that the left nasolabial fold was slightly shallower than the right (Fig. 1A). On the 6th day, the shallow left nasolabial fold became obvious, suggesting left facial nerve palsy (Fig. 1B). On the 8th day after admission, the patient developed ptosis of both corners of her mouth (Fig. 1C) and had difficulty wrinkling her forehead on both sides (Fig. 1G). Methylprednisolone pulse therapy (500 mg daily) was administered from the 9th to the 11th day, while the bilateral paralysis did not improve (Fig. 1D and H). Six months after admission, she was in good condition, with 7 mg of methylprednisolone daily, and had recovered from the paralysis (Fig. 1F and J).