Liaquat Ali1*, Adnan Khan2, Gholam Adeli1, Mohammad Alhatou1, Osama Elalamy1, Fazal Karim1, and Ambreen Iqrar1
Introduction: Facial nerve palsy is caused by a variety of disorders such as herpes zoster, GBS, otitis media, Lyme disease, HIV, etc. In peripheral lesions, the facial weakness that involves the forehead is usually due to a lesion of the ipsilateral facial nerve, but also can be caused by a central lesion (facial nerve nucleus and tract in the pons). Facial diplegia is an extremely rare condition that occurs in about 0.3% to 2.0% of facial palsy cases with the various central or peripheral disorder. The blink reflex is useful in detecting abnormalities in peripheral and central pathways. Methodology: This is a retrospective study, performed at the Neurophysiology unit, HMC, Doha, Qatar. There were 11 patients with bilateral facial weakness who visited for electrodiagnostic studies. Result: Neurologic manifestations including facial diplegia were 72.7% (8), hypo/areflexia were 72.7% (8), facial numbness was 63.6% (7) and lumbar puncture showed CSF albumin-cytological dissociation was 45.5% (5). The most common etiology for facial diplegia was Guillain- Barre syndrome was 81.9% (9). Direct facial nerve stimulation showed 81.8% (9) were bilateral facial nerve low CMAP amplitudes, blink reflex showed 88.8% (8) were bilateral absent responses and EMG showed 55.5% (5) were active denervation in bilateral facial muscles. Conclusion: Facial diplegia is an extremely rare condition which occurs with various central or peripheral diverse etiologies. Electrodiagnostic studies are useful in detecting abnormalities in peripheral and central pathways and prognostic marker in facial diplegia.