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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.

Original publication

DOI

10.1002/mus.24887

Type

Journal article

Journal

Muscle Nerve

Publication Date

12/2015

Volume

52

Pages

927 - 932

Keywords

Bell palsy, Guillain-Barré syndrome, Miller Fisher syndrome, bifacial weakness, facial diplegia, paraesthesia, Facial Paralysis, Guillain-Barre Syndrome, Humans, Muscle Weakness, Paresthesia