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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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| Published in: | BMJ case reports 2018-02, Vol.2018, p.bcr-2017-223214 |
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| container_start_page | bcr-2017-223214 |
| container_title | BMJ case reports |
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| creator | Karadan, Ummer Manappallil, Robin George Jayakrishnan, Chellenton Supreeth, Ramesh Naga |
| description | 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. |
| doi_str_mv | 10.1136/bcr-2017-223214 |
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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.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2017-223214</identifier><identifier>PMID: 29437741</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>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</subject><ispartof>BMJ case reports, 2018-02, Vol.2018, p.bcr-2017-223214</ispartof><rights>BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><rights>Copyright: 2018 © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><rights>BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b3714-3a6a4a3568aea39d7569cb9911f436218460a86a4cbd33ce59bf7d798a93bd183</citedby><cites>FETCH-LOGICAL-b3714-3a6a4a3568aea39d7569cb9911f436218460a86a4cbd33ce59bf7d798a93bd183</cites><orcidid>0000-0003-3973-6800</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836662/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5836662/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29437741$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karadan, Ummer</creatorcontrib><creatorcontrib>Manappallil, Robin George</creatorcontrib><creatorcontrib>Jayakrishnan, Chellenton</creatorcontrib><creatorcontrib>Supreeth, Ramesh Naga</creatorcontrib><title>Pontine haemorrhage disguised as Bell’s palsy</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>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.</description><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Anticholesteremic Agents - therapeutic use</subject><subject>Atorvastatin - therapeutic use</subject><subject>Bell Palsy - diagnosis</subject><subject>Bell's palsy</subject><subject>Blood pressure</subject><subject>Case reports</subject><subject>Cerebral Hemorrhage - complications</subject><subject>Cerebral Hemorrhage - diagnostic imaging</subject><subject>Cerebral Hemorrhage - physiopathology</subject><subject>Cerebral Hemorrhage - therapy</subject><subject>Clinical medicine</subject><subject>Diabetes</subject><subject>Diagnosis, Differential</subject><subject>Diuretics, Osmotic - therapeutic use</subject><subject>Face</subject><subject>Facial Paralysis - diagnostic imaging</subject><subject>Facial Paralysis - etiology</subject><subject>Facial Paralysis - physiopathology</subject><subject>Facial Paralysis - therapy</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Mannitol - therapeutic use</subject><subject>Middle Aged</subject><subject>Neural Pathways</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Paralysis</subject><subject>Perindopril - therapeutic use</subject><subject>Physical Therapy Modalities</subject><subject>Pons - diagnostic imaging</subject><subject>Pons - pathology</subject><subject>Reminder of Important Clinical Lesson</subject><subject>Stroke</subject><subject>Treatment Outcome</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqFkc1KAzEUhYMottSu3cmAGxHG5iaZZLIRtPgHBV0ouAuZmUw7ZX5q0hG68zV8PZ_ElKmlujGbG7jfPdxzD0LHgC8AKB8lqQ0JBhESQgmwPdQHEYlQSPy6v_PvoaFzc-wfBRYzeoh6RDIqBIM-Gj019bKoTTDTpmqsnempCbLCTdvCmSzQLrg2Zfn18emChS7d6ggd5L6a4aYO0MvtzfP4Ppw83j2MryZhQgWwkGqumaYRj7XRVGYi4jJNpATIGeUEYsaxjj2TJhmlqYlkkotMyFhLmmQQ0wG67HQXbVKZLDX10upSLWxRabtSjS7U705dzNS0eVdRTDnnxAucbQRs89Yat1RV4VLvRdemaZ0iGBMCAJh59PQPOm9aW3t7CqRkkZTC33uARh2V2sY5a_LtMoDVOg_l81DrPFSXh5842fWw5X-u74HzDkiq-b9q3-j2ktc</recordid><startdate>20180205</startdate><enddate>20180205</enddate><creator>Karadan, Ummer</creator><creator>Manappallil, Robin George</creator><creator>Jayakrishnan, Chellenton</creator><creator>Supreeth, Ramesh Naga</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3973-6800</orcidid></search><sort><creationdate>20180205</creationdate><title>Pontine haemorrhage disguised as Bell’s palsy</title><author>Karadan, Ummer ; Manappallil, Robin George ; Jayakrishnan, Chellenton ; Supreeth, Ramesh Naga</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b3714-3a6a4a3568aea39d7569cb9911f436218460a86a4cbd33ce59bf7d798a93bd183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Anticholesteremic Agents - therapeutic use</topic><topic>Atorvastatin - therapeutic use</topic><topic>Bell Palsy - diagnosis</topic><topic>Bell's palsy</topic><topic>Blood pressure</topic><topic>Case reports</topic><topic>Cerebral Hemorrhage - complications</topic><topic>Cerebral Hemorrhage - diagnostic imaging</topic><topic>Cerebral Hemorrhage - physiopathology</topic><topic>Cerebral Hemorrhage - therapy</topic><topic>Clinical medicine</topic><topic>Diabetes</topic><topic>Diagnosis, Differential</topic><topic>Diuretics, Osmotic - therapeutic use</topic><topic>Face</topic><topic>Facial Paralysis - diagnostic imaging</topic><topic>Facial Paralysis - etiology</topic><topic>Facial Paralysis - physiopathology</topic><topic>Facial Paralysis - therapy</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Mannitol - therapeutic use</topic><topic>Middle Aged</topic><topic>Neural Pathways</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Paralysis</topic><topic>Perindopril - therapeutic use</topic><topic>Physical Therapy Modalities</topic><topic>Pons - diagnostic imaging</topic><topic>Pons - pathology</topic><topic>Reminder of Important Clinical Lesson</topic><topic>Stroke</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karadan, Ummer</creatorcontrib><creatorcontrib>Manappallil, Robin George</creatorcontrib><creatorcontrib>Jayakrishnan, Chellenton</creatorcontrib><creatorcontrib>Supreeth, Ramesh Naga</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ case reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karadan, Ummer</au><au>Manappallil, Robin George</au><au>Jayakrishnan, Chellenton</au><au>Supreeth, Ramesh Naga</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pontine haemorrhage disguised as Bell’s palsy</atitle><jtitle>BMJ case reports</jtitle><addtitle>BMJ Case Rep</addtitle><date>2018-02-05</date><risdate>2018</risdate><volume>2018</volume><spage>bcr-2017-223214</spage><pages>bcr-2017-223214-</pages><issn>1757-790X</issn><eissn>1757-790X</eissn><abstract>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.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>29437741</pmid><doi>10.1136/bcr-2017-223214</doi><orcidid>https://orcid.org/0000-0003-3973-6800</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | BMJ case reports, 2018-02, Vol.2018, p.bcr-2017-223214 |
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| language | eng |
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| source | PubMed (Medline) |
| 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 |
| title | Pontine haemorrhage disguised as Bell’s palsy |
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