We report an unusual case of sudden onset lower motor neuron facial palsy in a 30-year-old male. It was subsequently diagnosed to be caused by silent mastoiditis of tuberculous aetiology. The diagnosis was based on the histology of granulations found during facial nerve decompression. The facial palsy resolved after initiating anti-tubercular therapy and surgical decompression. Our case is an uncommon case of acute onset infranuclear facial palsy due to tuberculosis, in the absence of any ear findings, resembling Bell's palsy.
Keywords: Facial palsy; silent mastoiditis; tuberculous mastoiditis.