Guillain-Barré Syndrome presenting with bilateral facial nerve paralysis: a case report

Abstract

Bilateral paralysis of the facial nerve is a relatively rare presentation and often indicates a serious underlying medical condition. Guillain-Barré syndrome needs to be considered, among others in the differential diagnoses of such presentation. We present here the case of a 35 year old female who presented with bilateral facial nerve paralysis due to the Guillain-Barré syndrome.

Unilateral facial palsy in Guillain-Barre syndrome (GBS): a rare occurrence

“…Facial palsy in GBS usually follows the limb weakness 9. However, in our patient, onset of facial weakness was simultaneous with that of limb weakness.…”

Rare encounter of unilateral facial nerve palsy in an adolescent with Guillain-Barré syndrome

“…GBS has been known to present with bilateral facial nerve palsy,2 and one recent report illustrates a 65-year-old patient who developed unilateral facial palsy simultaneously with lower limb weakness 3. Our patient initially presented with lower limb weakness, and then progressed to develop left facial weakness approximately 2 weeks after initial onset of symptoms.…”

“…Cranial nerve involvement has been reported in 45–75% of patients with GBS, with facial nerve involvement being the most common. Facial palsy is often bilateral,2 and rarely unilateral 3. We report a case of an adolescent girl who initially presented with a classical history of GBS and was making improvement; however, during the second week of illness, she developed unilateral facial palsy, which prolonged her illness; but she eventually made a good recovery.…”

Bilateral facial nerve palsy in a newly diagnosed diabetic patient with associated herpes labialis

“…Bilateral facial nerve paralysis unlike unilateral palsy is rarely idiopathic or Bell's. The variety of diseases that may present with bilateral facial paralysis are Guillain-Barre syndrome, [2] Lyme's disease, [3] sarcoidosis, [4] brain stem encephalitis, benign intracranial hypertension, leukemia, Melkersson-Rosenthal syndrome, diabetes mellitus, HIV infection, [5] syphilis, leprosy, [6] infectious mononucleosis, bilateral neurofibromas or trauma. Thus, the diagnostic workup for a patient with bilateral facial paralysis depends greatly on a meticulous history.…”