{
  "abstract": "Introduction We describe a case of complete hemifacial paralysis accompanied by transient gait disturbance due to ischaemic pontine infarction.Case Presentation A 55-year-old South Asian lady was brought to the emergency department following a brief period of gait disturbance. She had been diagnosed with right-sided Bell’s palsy a week prior and commenced on a short course of Prednisone. Her facial weakness was sudden in onset without associated hyperacusis, post-auricular pain, or taste disturbance. On examination, her gait disturbance had completely subsided, but her facial paralysis was evident and quantified as House-Brackmann grade V with the presence of Bell’s phenomenon. The remainder of her neurological examination was normal. She was hypertensive to 161/99 mmHg, which later resolved without treatment, and was found to have dyslipidaemia. She had no personal or family history of stroke.Diffusion weighted magnetic resonance imaging demonstrated acute infarction at the expected area of the right facial colliculus and fluid attenuated inversion recovery imaging revealed more microvascular changes than expected for age. She was commenced on dual antiplatelet and statin therapy and twenty-eight-day ambulatory cardiac monitoring.Conclusion Complete hemifacial paralysis is rarely ever caused by ischaemic infarction. There are fifteen other described cases, often with associated symptoms such as vertigo, dysarthria, nausea and vomiting, or limb paraesthesia. Routine neuroimaging is not recommended for cases of suspected Bell’s palsy due to low misdiagnosis rates but should be considered in cases with any additional neurological disturbance or the presence of multiple vascular risk factors.",
  "authors": [
    {
      "affiliations": [
        "Neurology, Prince of Wales Hospital, Randwick, NSW, Australia"
      ],
      "name": "Henry Jiang"
    },
    {
      "affiliations": [
        "Neurology, Prince of Wales Hospital, Randwick, NSW, Australia"
      ],
      "name": "Leon S Edwards"
    }
  ],
  "title": "3450 Case report – complete hemifacial paralysis secondary to pontine infarction",
  "uid": "1470a4d5-35c8-51b4-81b1-6a722f581d43"
}