Facial diplegia (bilateral facial paralysis) is a rare clinical finding that can be the presenting symptom in a wide range of diseases.1 It occurs in about 50% of patients with Guillain-Barré syndrome (GBS). Guillain-Barré syndrome causes regional and functional variants with unusual features. Ropper described four patients with facial diplegia and distal limb paraesthesias, and he defined them as having a rare variant form of GBS because of shared clinical, electrophysiological, and CSF features.2 The aetiology and nosological position of facial diplegia presenting in this variant form is still controversial. We experienced a patient who had bilateral facial paralysis, distal limb paraesthesias, and diminished reflexes whose contrast enhanced three dimensional MRI (3-D MRI) showed enhancing lesions in the bilateral facial nerves.

A 27 year old woman had nasal discharge and coughing. One week later she noticed paraesthesias in her fingers and toes. Nine days after the …