{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:42:05Z","timestamp":1761745325588},"reference-count":9,"publisher":"California Digital Library (CDL)","issue":"3","license":[{"start":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T00:00:00Z","timestamp":1595203200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Patients with acute unilateral upper and lower facial palsy frequently present to the emergency department fearing they have had a stroke, but many cases are benign Bell\u2019s palsy. \n\nCase Report: We present a rare case of a medial pontomedullary junction stroke causing upper and lower hemifacial paralysis associated with severe dysphagia and contralateral face and arm numbness. \n\nConclusion: Although rare, pontine infarct must be considered in patients who present with both upper and lower facial weakness. Unusual neurologic symptoms (namely diplopia, vertigo, or dysphagia) and signs (namely gaze palsy, nystagmus, or contralateral motor or sensory deficits) should prompt evaluation for stroke.<\/jats:p>","DOI":"10.5811\/cpcem.2020.5.46965","type":"journal-article","created":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T19:31:21Z","timestamp":1597260681000},"page":"380-383","source":"Crossref","is-referenced-by-count":1,"title":["Medial Pontomedullary Stroke Mimicking Severe Bell\u2019s Palsy: A Case Report"],"prefix":"10.5811","volume":"4","author":[{"given":"Benjamin","family":"Boodale","sequence":"first","affiliation":[{"name":"Kern Medical, Department of Emergency Medicine, Bakersfield, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manish","family":"Amin","sequence":"additional","affiliation":[{"name":"Kern Medical, Department of Emergency Medicine, Bakersfield, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katayoun","family":"Sabetian","sequence":"additional","affiliation":[{"name":"Kern Medical, Department of Neurology, Bakersfield, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Quesada","sequence":"additional","affiliation":[{"name":"Kern Medical, Department of Emergency Medicine, Bakersfield, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Torrico","sequence":"additional","affiliation":[{"name":"Ross University School of Medicine, Department of Medicine, Miramar, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2020,7,20]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"May M and Klein SR. Differential diagnosis of facial nerve palsy. Otolaryngol Clin North Am. 1991;24(3):613-45.","DOI":"10.1016\/S0030-6665(20)31118-X"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Gilden DH. Clinical practice. Bell\u2019s palsy. N Engl J Med. 2004;351(13):1323-31.","DOI":"10.1056\/NEJMcp041120"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Murakami S, Mizobuchi M, Nakashiro Y, et al. Bell palsy and herpes simplex virus: identification of viral DNA in endoneurial fluid and muscle. Ann Intern Med. 1996;124:27-30.","DOI":"10.7326\/0003-4819-124-1_part_1-199601010-00005"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Fahimi J, Navi BB, Kamel H. Potential misdiagnosis of Bell\u2019s palsy in the emergency department. Ann Emerg Med. 2014;63(4):428-34.","DOI":"10.1016\/j.annemergmed.2013.06.022"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Peitersen E. Bell\u2019s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies and different etiologies. Acta Oto-Laryngologica. 2002;(549):4-30.","DOI":"10.1080\/000164802760370736"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Yoneoka Y, Ikeda R, Aizawa N, et al. Medial Pontomedullary Junctional Infarction Presenting Vertigo, Ipsilateral Facial Paresis, Contralateral Thermal Hypoalgesia and Dysphagia Without Lateral Gaze Palsy, Curtain Sign and Hoarseness: A Case Presentation of a Novel Brain Stem Stroke Syndrome With Sensory Disturbance-Based Dysphagia and Review of the Literature. Oxf Med Case Reports. 2019;2019(1):omy121.","DOI":"10.1093\/omcr\/omy121"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Adour KK, Byl FM, Hilsinger RL, et al. The true nature of Bell\u2019s palsy: analysis of 1,000 consecutive patients. Laryngoscope. 1978;88(5):787-801.","DOI":"10.1002\/lary.1978.88.5.787"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Vanopdenbosch LJ, Verhoeven K, Casselman JW. Bell\u2019s palsy with ipsilateral numbness. J Neurol Neurosurg Psychiatry. 2005;76(7):1017-8.","DOI":"10.1136\/jnnp.2004.043059"},{"key":"ref8","unstructured":"Oppenheim C, Stanescu R, Dormont D, et al. False-negative Diffusion-Weighted MR Findings in Acute Ischemic Stroke. AJNR AM J Neuroradiol. 2000;21(8):1434-40."}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T19:11:01Z","timestamp":1600283461000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/3tg861kn"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,20]]},"references-count":9,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,8,6]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2020.5.46965","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"},{"type":"print","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2020,7,20]]}}}