I recently saw a 7 year old girl who has had recurrent bouts of Bell Palsy since the age of two; both parents have had Bell Palsy in the past. She has had 5 episodes over 5 years with the parents acting swiftly to seek treatment. All episodes have settled with steroid treatment within a week without a significant deficit. She is said to get dry cracked and swollen lips with each episode but most recently on her sixth episode, I reviewed her within a couple of days but there were no such clinical signs that would suggest Melkersson Rosenthal syndrome.

Currently she has slight ocular surface symptoms, 1mm lagophthalmus, and a weak depressor anguli iris on the left. Has anyone seen anything similar? Should I consider further work up?