Isolated facial diplegia in Guillain–Barré syndrome

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Isolated facial diplegia in Guillain–Barré syndrome

Post by RitaA » Mon 21 Sep 2015 20:34 ... 0B1.f02t04
Muscle & Nerve

Invited Review

Isolated facial diplegia in Guillain–Barré syndrome: Bifacial weakness with paresthesias

Benjamin R. Wakerley MD, PhD1,2,* and
Nobuhiro Yuki MD, PhD3

Article first published online: 12 SEP 2015

DOI: 10.1002/mus.24887


Bell palsy; bifacial weakness; Guillain–Barré syndrome; Miller Fisher syndrome; paraesthesia; facial diplegia


Bifacial weakness with paresthesias (BFP) is a subtype of Guillain–Barré syndrome defined by rapidly progressive bilateral facial weakness in the absence of other cranial neuropathies, ataxia, or limb weakness. Many patients also complain of distal limb paresthesias and display diminished or absent deep tendon reflexes. BFP is a localized form of Guillain–Barré syndrome and is thought to be caused exclusively by demyelinating- rather than axonal-type neuropathy. Patients with BFP do not display anti-ganglioside IgG antibodies. Since it is rare, many physicians are unfamiliar with BFP, as bilateral facial weakness is more commonly associated with sarcoidosis, Lyme disease, or meningeal pathology. Many patients diagnosed with bilateral Bell palsy may instead have BFP. In this review, we highlight the clinical features of BFP and outline diagnostic criteria.

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