Facial nerve palsy following bee sting: a case report


  • Khairullah Bin Anuar Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences University Sains Islam Malaysia, Nilai Negeri Sembilan, Malaysia
  • Maimunah Binti Abdul Munaaim Department of Ophthalmology, Faculty of Medicine and Health Sciences University Sains Islam Malaysia, Nilai, Negeri Sembilan Malaysia




Bee sting, Facial nerve palsy, Bells palsy, Oral steroid, House Brackmann classification


One of the most common insect poisoning is bee sting. It can produce local symptoms such as pain, redness, and fever following a local pain. Rarely, anaphylaxis, myocardial infarction, organ failure, epilepsy and other neurological diseases have been reported. Lower motor neuron facial nerve palsy is one of the common diseases of the Otorhinolaryngology clinic. Although it is usually idiopathic, trauma and tumors are the two most common causes. Usually, it is diagnosed clinically and the grade of palsy is based on House Brackmann Classification. We present a case of left Bell’s palsy due to bee sting. A 21-year-old male patient was referred to our clinic for persistent incomplete eye closure for two weeks duration. Upon further history, he complained that prior to the left sided facial weakness he was stung by a bee the night before on his left toe and developed the facial weakness when he woke up in the morning. He did not get immediate treatment. Clinically he had Grade III left lower motor neuron facial nerve palsy. Other ear, nose and throat examinations were unremarkable. He was treated with oral steroid and eye care. One week upon follow up, his facial weakness was completely resolved.


Yildiz E. Facial Paralysis due to Bee sting. Med Sci Int Med J. 2019.

House JW. Facial nerve grading systems. Laryngoscope. 1983;93:1056-69.

Jeffrey D, Nandini K. Bell's palsy: diagnosis and management. Am Fam Phys. 2007;76(7):997-1002.

Fitzgerald KT, Flood AA. Hymenoptera stings Clinical Techniques in Small Animal Practice. Am Fam Phys. 2006;21(4):194-204.

Bresolin NL, Carvalho FC, Goes, JC. Acute renal failure following massive attack by Africanized bee stings. Pediatr Nephrol. 2002;17:625-7.

Boz C, Velioglu S, Ozmenoglu M. Acute disseminated encephalomyelitis after bee sting. Neurol Sci. 2003;23:313-5.

Choi MY, Cho SH. Optic neuritis after bee sting. Korean J Ophthalmol. 2000;14:49-52.

Viswanathan S, Muthu V, Singh AP, et al. Middle cerebral artery infarct following multiple bee stings. J Stroke Cerebrovasc Dis. 2012;21:148-50.

Sachdev A, Mahapatra M, D’Cruz S et al. Wasp sting induced neurological manifestations. Neurol India. 2002;50:319.

Aydın M, Kabakuş N, Akarsu S. Arı sokması sonrası gelişen nefrotik sendrom olgusu. Flrat Tlp Dergisi. 2006;11:71-2.

Banovcin P, Havlicekova Z, Jesenak M. Severe quadriparesis caused by wasp sting. Turk J Pediatr. 2009;51(5):485-8.






Case Reports