DORSAL PONTINE INFARCT PRESENTED WITH ISOLATED IPSILATERAL PERIPHERAL-TYPE FACIAL PALSY

초록

Background There have been few stroke cases presented with peripheral type facial palsy. Here, we reported two cases of a patient with dorsal pontine infarction who showed ipsilateral peripheral type facial palsy and were evaluated with blink reflex. Case Report 1: A 68-year-old woman found sudden-onset left peripheral type facial palsy. She had the history of hypertension and diabetes mellitus. The initial neurologic exam showed left peripheral type facial palsy with minimal facial paresthemia. Nystagmus, horner syndrome post-auricular pain, hearing problems or dysguesia was not shown, either. Brain diffusion MR imaged revealed an acute infarction in the dorsal lower pons. Blink reflex test showed the abnormality in the R1 and R2. Two weeks later, her symptoms disappeared. However, the abnormality on blink reflex test persisted. Case Report 2 A 73-year-old woman suddenly developed left peripheral type facial palsy. She had the history of dyslipidemia diabetes mellitus. On admission, the neurologic exam showed the peripheral type facial palsy without any other symptoms. Post-auricular pain, hearing problems or dysguesia was not shown, either. Brain diffusion MR imaged revealed an acute infarction in the dorsal lower pons. Blink reflex test showed the abnormality in the R1 and R2. Eight days later, her symptoms improved. Conclusion: Our cases suggested that interpretation of blink reflex test should be cautious to differentiate the etiology of facial palsy.