BFP, bifacial weakness with paresthesias secondary to trauma: a case report

BFP, bifacial weakness with paresthesias is a rare variant of Guillain-Barré syndrome (GBS). Here, we detail the diagnosis and treatment process of a patient with BFP secondary to head trauma to highlight its importance.

A 47-year-old man presented with bilateral peripheral facial paralysis, hearing loss, and sensory impairment in both lower limbs following a car accident. Temporal bone fracture was first considered as the cause of facial palsy. We gave glucocorticoid therapy to the patient, but it was ineffective, facial nerve decompression surgery was planned as a consideration. However, diminished tendon reflexes was noted on the 12th day post-trauma, then cerebrospinal fluid (CSF) testing and anti-ganglioside antibodies were performed. Based on the medical history and Laboratory testing, the patient was diagnosed with BFP, a rare variant of GBS. Plasma exchange therapy was performed on the patient. At six-month follow-up, except for hearing loss, the other symptoms had almost returned to normal.

In this article, we report a case of BFP secondary to head trauma. We emphasize that in patients with post-traumatic bilateral facial nerve paralysis, a comprehensive neurological examination is essential for accurate diagnosis and to avoid unnecessary medications or surgery.