Bell palsy is regarded as a peripheral disorder singularly affecting the seventh cranial nerve. Although subjective sensory phenomena are often communicated by such patients, an objective hypalgesia cannot be demonstrated. We have studied the cases of two patients who developed a sudden onset of unilateral peripheral facial paresis associated with von Frey hair sensory loss over the ipsilateral first and second divisions of the trigeminal nerve. This combination of cranial nerve signs often implicates structural disease of the nervous system. Yet our two patients never developed additional neurologic signs and eventually recovered without clinical residua. Sensory signs in the trigeminal distribution may occur in an otherwise typical Bell palsy, and they do not always warrant extensive neuroradiologic investigation.
Spector RH, Schwartzman RJ. Benign Trigeminal and Facial Neuropathy. Arch Intern Med. 1975;135(7):992–993. doi:10.1001/archinte.1975.00330070114020