Pontine haemorrhage disguised as Bell's palsy.

Isolated facial nerve palsy is a common presentation of Bell's palsy, but rarely seen in pontine lesions. The patient being reported is a middle-aged man who developed isolated facial nerve palsy and was initially treated as Bell's palsy. However, on MRI of the brain, he was found to have pontine haemorrhage.

Twenty-Four Syndrome: An Untold Presentation of Pontine Hemorrhage.

Pontine hemorrhages are relatively uncommon. Various atypical manifestations of pontine stroke like eight-and-a-half syndrome, fifteen-and-a-half syndrome, and sixteen syndrome have been described in the past. We came across a case of pontine bleed that presented with bilateral facial palsy, bilateral horizontal gaze palsy, and contralateral sensorineural hearing loss accounting to the hitherto not described "twenty-four syndrome" with Horner's syndrome and left hemiparesis.