A Rare Case of Persistent Idiopathic Facial Paralysis Since Infancy: A 44-Year Diagnostic and Functional Challenge

Idiopathic facial nerve paralysis is usually seen in adults and often resolves spontaneously; however, persistence from infancy into adulthood is exceptionally rare. We report a 45-year-old woman with right-sided facial paralysis since one year of age. Examination revealed facial asymmetry, muscle atrophy, and lagophthalmos. Radiological findings were unremarkable, and advanced tests, such as electroneurography and electromyography, were not performed due to socioeconomic limitations. The case is unique because of its extraordinary chronicity of more than four decades without intervention. It emphasizes the importance of early diagnosis, use of advanced imaging where feasible, and timely rehabilitation to minimize long-term functional and psychosocial morbidity. It highlights the role of thorough clinical assessment in limited-resource settings, the limitations of conventional diagnostics, and the importance of considering long-term functional and psychosocial consequences in patient management.