A 56-year-old man presented with right-sided drooping of the mouth corner and eyelid, along with weakness in the left lower limb. His MRI revealed a corona radiata lacunar infarction on the left and an acute infarction on the right. However, the needle electromyography (EMG) results were unremarkable. It was determined that his unilateral peripheral facial paralysis (PFP)-like symptoms were secondary to bilateral corona radiata infarctions. This case highlights that some patients with cerebral strokes may present with PFP-like symptoms. To minimize misdiagnosis, clinicians should consider the possibility of central lesions manifesting as PFP.
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