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 ha...

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Bibliographic Details
Published in:BMJ case reports 2018-02, Vol.2018, p.bcr-2017-223214
Main Authors: Karadan, Ummer, Manappallil, Robin George, Jayakrishnan, Chellenton, Supreeth, Ramesh Naga
Format: Article
Language:English
Subjects:
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Anticholesteremic Agents - therapeutic use
Atorvastatin - therapeutic use
Bell Palsy - diagnosis
Bell's palsy
Blood pressure
Case reports
Cerebral Hemorrhage - complications
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - physiopathology
Cerebral Hemorrhage - therapy
Clinical medicine
Diabetes
Diagnosis, Differential
Diuretics, Osmotic - therapeutic use
Face
Facial Paralysis - diagnostic imaging
Facial Paralysis - etiology
Facial Paralysis - physiopathology
Facial Paralysis - therapy
HIV
Human immunodeficiency virus
Humans
Hypertension
Magnetic Resonance Imaging
Male
Mannitol - therapeutic use
Middle Aged
Neural Pathways
NMR
Nuclear magnetic resonance
Paralysis
Perindopril - therapeutic use
Physical Therapy Modalities
Pons - diagnostic imaging
Pons - pathology
Reminder of Important Clinical Lesson
Stroke
Treatment Outcome
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Description
Summary: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. He was managed conservatively and improved. Pontine haemorrhage as an aetiology for isolated facial nerve palsy is a rare scenario, which often goes misdiagnosed and treated as Bell’s palsy.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2017-223214