Background and purpose: We report a case of facial diplegia complicating a bilateral internal carotid artery dissection.
Case description: A 49-year-old patient presented with unilateral headache and oculosympathetic paresis. Cerebral angiography revealed a bilateral internal carotid artery dissection. A few days later, the patient developed a facial diplegia that regressed after arterial recanalization. An arterial anatomic variation may explain this ischemic complication of carotid dissection.
Conclusions: Double carotid dissection should be included among the causes of bilateral seventh nerve palsy.