The most common etiology of peripheral-type facial palsy is Bell's palsy (54%), followed respectively by herpes zoster otitis (Ramsay-Hunt syndrome) (20%), traumatic palsy (12%), and others (4%). A 71-year-old man presented with left peripheral-type facial palsy (House-Brackmann classification IV), left sudden deafness, vertigo, and wide-based gait. Brain magnetic resonance imaging demonstrated left pontine and cerebellar infarctions. The National Institutes of Health Stroke Scale was 4. Isolated pontine infarction rarely presents with isolated peripheral-type facial palsy. The case's unilateral peripheral-type facial palsy was complicated with ipsilateral sudden deafness, vertigo and other cerebellar signs; it was therefore attributable to a brainstem lesion rather than Bell's palsy, the common cause of peripheral-type facial palsy.
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