ROLE OF MAGNETIC-RESONANCE-IMAGING IN THE DIAGNOSIS OF BILATERAL FACIAL PARALYSIS

Bilateral facial paralysis (BFP) is a rare clinical finding that may b e caused by Guillain-Barre syndrome, a medical emergency. The differen tial diagnosis of BFP is lengthy but can be narrowed to a limited grou p of disorders by the patient's history and physical examination. The most important diagnostic tests to obtain initially are the lumbar pun cture and magnetic resonance imaging (MRI) scan with gadolinium contra st enhancement. Based on the MRI and lumbar puncture findings, additio nal tests may be appropriately ordered. The diagnosis of bilateral Bel l's palsy is made by exclusion of other disorders. This report present s five cases of BFP (Guillain-Barre syndrome, herpes simplex polyneuri tis, meningeal lymphoma, and two cases of bilateral Bell's palsy) in w hich MRI imaging helped in the diagnosis and subsequent management of the patient. The appropriate sequence of diagnostic studies for patien ts with BFP is discussed.