Differential Diagnoses for Bilateral Facial Palsy

Differential Diagnoses for bilateral facial palsy using the VITAMINS ABCDEG mnemonic

Vascular

  • Brainstem cavernous hemangioma

Infectious/Inflammatory

Viral

  • Human Immunodeficiency Virus (HIV)

  • Infectious Mononucleosis

  • HTLV-1

  • Coxsakie

  • CMV

  • Influenza

  • Mumps

  • Poliomyelitis

Bacterial

  • Meningitis

  • Leprosy

  • Scarlet fever

  • Otitis media (bilateral)

  • Tuberculosis

  • Tetanus

Spirochete, protozoa, fungi

  • Lyme Disease

  • Malaria

  • Cryptococcal Meningitis

Trauma/Toxin

  • Skull fracture

Congenital

  • Melkersson-Rosenthal Syndrome

  • Mobius Syndrome

Degenerative/Drug

  • Kennedy Syndrome

Autoimmune/Allergic

  • Amyloidosis

  • Guillain-Barre Syndrome

  • Multiple Sclerosis

  • Myasthenia Gravis

  • Sarcoidosis (meningeal infiltration or Heerfordt syndrome)

  • Temporal arteritis

Iatrogenic/Idiopathic

  • Bells Palsy (rarely bilateral)

  • Forceps birth trauma

  • Parotid Surgery

  • Rabies antiserum inoculation

  • Vaccine

Neoplastic/nutritional

  • Leukemia

  • Lymphoma

  • Meningeal infiltration by tumor

  • Neurofibromatosis

  • Pontine glioma