Lacunar Pontine Infarct Presenting as Ipsilateral Lower Motor Neuron Facial Palsy: A Case Report

Most cases of unilateral facial paralysis are caused by Bell’s palsy, which is usually an idiopathic lower motor neuron facial nerve palsy. However, some cases result from an infarction of the ipsilateral facial nerve region in the pons, which mimics Bell’s palsy and is referred to as a pontine stroke. This study reports a case of a 63-year-old male who presented with complaints of dizziness, giddiness, nausea, vomiting, and headache for 12 hours. He developed facial deviation to the right and slurred speech seven hours before presentation. Additionally, he had a history of hypertension and diabetes. No signs of meningeal irritation were noted. Cranial nerve examination and MRI were suggestive of a left lacunar pontine infarct. The patient was given aspirin, clopidogrel, and atorvastatin along with antihypertensive medications and other symptomatic treatments. He was discharged after seven days in a stable condition. This report highlights the importance of clinicians being aware of the need to investigate for stroke when a patient presents with peripheral facial nerve palsy.