Bilateral facial nerve palsy secondary to an atypical presentation of Gullain-Barré syndrome

Bilateral simultaneous facial nerve palsy is an extremely rare clinical entity and may occur in association with a variety of neurological, infectious, neoplastic or degenerative disorders. We describe a patient, who presented with facial diplegia and normal reflexes on examination. During the entire hospitalization, he developed no motor weakness and remained ambulatory. Whether treatment is warranted for this and other milder variants of Gullain-Barre syndrome is also discussed. Atypical presentations with preserved or brisk reflexes, can be a diagnostic dilemma.