Clinical Practice and Cases in Emergency Medicine

Introduction: Unilateral facial weakness is a concerning symptom, particularly in a resources poor setting. Distinguishing between peripheral and central causes is critical to the evaluation, treatment, and prognosis.

Case report: An unusual case of recurrent, transient Bell’s palsy occurring during ascent in a commercial airplane is presented.

Conclusion: Emergency physicians should be aware of the possibility of barotrauma to the facial nerve (cranial nerve VII) during flights because accurately diagnosing this condition can prevent costly aircraft diversion, calm the passenger’s anxiety, and forgo an expensive medical workup.