9year old female with c/o deviation of mouth. On rx 3days. Details not available. No other significant history of fever or any other complaints. Examination is normal. Except relatives didnt notice drooping of eyelid and partial closureof eyelid. If ask to wrikle forehead its symmetrical and no forehead muscle weakness noted. Kindly discuss differentials.



Diagnosis:LMN Facial palsy or bells palsy. No need of investigations etiology Hsv varicella sometimes no etiology is forthcoming test for taste sensation where its lost in anterior two thirds of tongue. treatment: prednisone for 2 Weeks with tapering physiotherapy

Dr sree. In LMN lesion i think forehead musles should also have affected. Here they are spared. No affection to forehead muscles.

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Facial Palsy____ Causes May be due to Exposure to cold or due to Viral infection or herpes zoster___Line of treatment___ Prednisone 80mg po tid for three-day than60mg tid for three-day than 20mg po for three-day than discontinue use course of the treatment to begin immediately after onset of Facial nerve Palsy There is little benefits in starting steroids after four days__Tab Neurobion Fort 1__1. Moisol eye drop _____Hot application & Exercises T

Bells, steroids in appropriate tapering doses for 3 _ 6 weeks, care of eyes by using spects, upward facial massage, observation for recovery. If progression in situation, with other neuro involvement, investigate further by doing mri

correct me if iam wrong. In bells palsy LMN lesion wirnkling of forehead should have affected. But sparing of forehead worries me and points towards UMN lesion and thats why i am thinking of other diagnosis.

Then get an MRI,, that will clear the doubt

Facial palsy 7th nerve or Bells palsy. Try to evaluate the underlying cause like infective focus in tooth,ear or throat. Treat with AB Inj dexamethasone I'm,iv stat. Inj B/c iv or im __ 7days

Antiinflammatory for 5_7 days Oral steroids for 7_10 days in tapering doses.

Isolated affection of face without other signs and symptoms goes more in favour of Bells palsy but since forehead muscles are not affected MRI should be done

bells palsy. Evaluate for other causes. Steroids can be tried. Artificial Tear drops (refresh) for both eyes. Follow up after a week.

Sometimes Facial Palsy Can Present Without Forehead Involvement. Start Treatment And Investigate To Rule Out Underlying Cause.

Partial facial palsy ...definitly .. Antibiotic/Antiinflammatory necessary

Bell's palsy

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