Science and Education Publishing American Journal of Medical Case Reports 2374-216X 4 2 2016 3 2 A Rare Cause of Bilateral Facial Palsy 62 64 EN Ahmet Z. Burakgazi Department of Medicine, Division of Neurology, Roanoke Memorial Hospital; Assistant Professor of Medicine (Neurology), Virginia Tech Carilion School of Medicine and Research Institute, Roanoke, VA. James W. Schmidley AJMCR2016428 10.12691/ajmcr-4-2-8 2015 10 16 2016 2 4 2016 2 29 HIV infection can cause neurological complications at all stages of the disease. Bilateral facial paralysis is not common in HIV, and more likely to have a systemic cause such as GBS, brain stem encephalitis, sarcoidosis, Lyme disease, syphilis or bacterial meningitis. Although HIV-associated bilateral facial palsy is very rare, it should be included in the differential diagnosis in unexplained cases, particularly in high-risk patients. We report a unique case of bilateral facial nerve palsy as an initial presenting symptom of AIDS, with an updated literature review.