The Ultimate Poker Face: A Case Report of Facial Diplegia, a Guillain-Barré Variant.

Clin Pract Cases Emerg Med

Brooke Army Medical Center, Department of Emergency Medicine, Fort Sam Houston, Texas.

Published: May 2020

Introduction: Facial diplegia, a rare variant of Guillain-Barré syndrome (GBS), is a challenging diagnosis to make in the emergency department due to its resemblance to neurologic Lyme disease.

Case Report: We present a case of a 27-year-old previously healthy man who presented with bilateral facial paralysis.

Discussion: Despite the variance in presentation, the recommended standard of practice for diagnostics (cerebrospinal fluid albumin-cytological dissociation) and disposition (admission for observation, intravenous immunoglobulin, and serial negative inspiratory force) of facial diplegia are the same as for other presentations of GBS.

Conclusion: When presented with bilateral facial palsy emergency providers should consider autoimmune, infectious, idiopathic, metabolic, neoplastic, neurologic, and traumatic etiologies in addition to the much more common neurologic Lyme disease.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220008PMC
http://dx.doi.org/10.5811/cpcem.2020.2.45556DOI Listing

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