AI Article Synopsis
- Facial paralysis often shows signs like drooping on one side of the mouth and difficulty closing the eye, with common causes being Bell's palsy and Ramsay-Hunt syndrome.
- A case study discusses a man in his 50s who initially seemed to have Bell's palsy but was later found to have a pontine infarction affecting his facial nerve after further examination.
- The report suggests that doctors should reconsider initial imaging results in similar cases, since early or posterior circulation infarctions can often be missed in diffusion-weighted imaging.
Article Abstract
Facial paralysis presents as unilateral mouth drooping and lagophthalmos. The main causes of peripheral facial paralysis are Bell's palsy and Ramsay-Hunt syndrome. However, rarely occurring pontine infarctions of the facial nucleus also manifest a lower motor neuron pattern of facial paralysis. We report a case of a man in his 50s who presented to the emergency department with unilateral peripheral facial paralysis. The initial diffusion-weighted images were unremarkable, and the patient was managed as per guidelines for hypertensive encephalopathy or Bell's palsy. On the 3rd day after admission, he was diagnosed with left pontine infarction and suspected infarction of the left anterior inferior cerebellar artery. We propose that in similar cases, re-examination of imaging results should be considered, as diffusion-weighted imaging is characteristically prone to generate false-negative results in patients with early onset or posterior circulation infarction.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057195 | PMC |
| http://dx.doi.org/10.1136/bcr-2023-259534 | DOI Listing |
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