Kl. Ramsey et Lg. Kaseff, ROLE OF MAGNETIC-RESONANCE-IMAGING IN THE DIAGNOSIS OF BILATERAL FACIAL PARALYSIS, The American journal of otology, 14(6), 1993, pp. 605-609
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.