{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:10:06Z","timestamp":1790226606967,"version":"4.1.0"},"reference-count":12,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,4,12]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>Facial paralysis presents as unilateral mouth drooping and lagophthalmos. The main causes of peripheral facial paralysis are Bell\u2019s palsy and Ramsay-Hunt syndrome. However, rarely occurring pontine infarctions of the facial nucleus also manifest a lower motor neuron pattern of facial paralysis. We report a case of a man in his 50s who presented to the emergency department with unilateral peripheral facial paralysis. The initial diffusion-weighted images were unremarkable, and the patient was managed as per guidelines for hypertensive encephalopathy or Bell\u2019s palsy. On the 3rd day after admission, he was diagnosed with left pontine infarction and suspected infarction of the left anterior inferior cerebellar artery. We propose that in similar cases, re-examination of imaging results should be considered, as diffusion-weighted imaging is characteristically prone to generate false-negative results in patients with early onset or posterior circulation infarction.<\/jats:p>","DOI":"10.1136\/bcr-2023-259534","type":"journal-article","created":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T02:01:02Z","timestamp":1714096862000},"page":"e259534","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Acute peripheral facial paralysis caused by tegmental pontine infarction"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2039-7992","authenticated-orcid":false,"given":"Yuta","family":"Yoshino","sequence":"first","affiliation":[{"name":"Internal Medicine, Saitama Citizens Medical Center, Saitama-shi, Saitama, Outside of the US, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Gono","sequence":"additional","affiliation":[{"name":"Internal Medicine, Saitama Citizens Medical Center, Saitama-shi, Saitama, Outside of the US, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Tsuboi","sequence":"additional","affiliation":[{"name":"Internal Medicine, Saitama Citizens Medical Center, Saitama-shi, Saitama, Outside of the US, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,25]]},"reference":[{"key":"2025082709562490000_17.4.e259534.1","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2377-9-25","article-title":"Pontine infarction with pure motor hemiparesis or Hemiplegia: a prospective study","volume":"9","author":"Ling","year":"2009","journal-title":"BMC Neurol"},{"key":"2025082709562490000_17.4.e259534.2","first-page":"261","article-title":"Risk factors profile and clinical outcome of ischemic stroke patients admitted in a Department of internal medicine and classified by TOAST classification","volume":"25","author":"Pinto","year":"2006","journal-title":"Int Angiol"},{"key":"2025082709562490000_17.4.e259534.3","first-page":"1434","article-title":"False-negative diffusion-weighted MR findings in acute ischemic stroke","volume":"21","author":"Oppenheim","year":"2000","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025082709562490000_17.4.e259534.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60151-2"},{"key":"2025082709562490000_17.4.e259534.5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.1.165"},{"key":"2025082709562490000_17.4.e259534.6","doi-asserted-by":"publisher","DOI":"10.1080\/000164802760370736"},{"key":"2025082709562490000_17.4.e259534.7","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000038692.17290.24"},{"key":"2025082709562490000_17.4.e259534.8","doi-asserted-by":"publisher","DOI":"10.1016\/0090-3019(95)00195-6"},{"key":"2025082709562490000_17.4.e259534.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2004.04.005"},{"key":"2025082709562490000_17.4.e259534.10","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s10072-008-0999-x","article-title":"Sudden deafness without vertigo as a sole manifestation of AICA infarct","volume":"29","author":"Gerace","year":"2008","journal-title":"Neurol Sci"},{"key":"2025082709562490000_17.4.e259534.11","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.11.118","article-title":"Clinical study of seven patients with infarction in territories of the anterior inferior cerebellar artery","volume":"26","author":"Ogawa","year":"2017","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2025082709562490000_17.4.e259534.12","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.551234"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-259534","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:56:35Z","timestamp":1756313795000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-259534"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":12,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,25]]},"published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1136\/bcr-2023-259534"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-259534","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}