A Rare Etiology of Peripheral Facial Paralysis in the Emergency Department: A Case Report

Peripheral facial paralysis is a common reason for emergency department visits. It is distinguished from central facial paralysis by the involvement of the entire musculature of the affected hemiface. In most cases, it is benign and caused by an infection. In the emergency department, it is typically triaged as a minor emergency. However, in rare cases, it may be part of Millard-Gubler syndrome (MGS), resulting from a vascular lesion, most notably a stroke, affecting the pons. The following case describes a patient who presented with peripheral facial paralysis, later diagnosed as a pontine ischemic stroke. It aims to raise awareness among emergency physicians about the risk of prematurely dismissing peripheral facial paralysis as benign.