A 24 years female attend op having c /o fever 2 days ago after that unable to close left eye and deviation of mouth left side of face and dribbling of saliva left side mouth, what is the diagnosis and treatment for the patient and differential diagnosis for the patient?

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Left Bell 's palsy . D.D is : Ramsay hunt syndrome - Bell's palsy with ear involvement caused by herpes zoster infection. HIV infection . Rx : Systemic steroids for 3 to 4 weeks In tapering dose. Tab . Vit- B1 , B-6 , B -12 for 1 month . Acyclovir systemic if HZV infection is suspected . Antibiotic eye drops & , ointments , artificial tears Frequently. frequent follow ups ; to look for development of exposure keratitis & treat it if needed. Recovery may take 1 & half to 2 months & may be incomplete. If lagophthalmos is severe , tarsorrhaphy may needed.

I will go with Dr.Harshad Gajjar.
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Healing Bell's s palsy. Differential diagnosis 1.ramsay hunt syndrome. 2.guillain barre syndrome. Check for Bell's phenomena. Eye findings are lagophthalmos. Slit lamp examination for cornea exposure Topical lubricants Eye patching suggestive.. Review the patient

Advice: CBP,ELISA or Western blot.CT
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Left sided facial palsy with H/of fever most probable viral pathology treat with systemic steroids vitamin B12 lubricant and antibiotic eye/drops examine corneal regularly

Bell's palsy

LEFT BELLS PALSY CAUSING LAPIPHTHALMOS NEUROLIGIST CONDUKTATION PROTECT CORNEA DURING NIGHT PUT EYE OINT TO PREVENT EXPOSURE KERATITIS DUE TO LAPIPHTHALMOS

This is left sided facial nerve palsy...investigate some blood sugar thyroid profile nd left ear also it's may be due to reactivation of herpes..so if u suspect that add acyclovir and steroids wd nsaids and care of eye properly

With add some mvi with mecobalamine
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Lt sided Bells palsy possibly due to herpes zoster infection one point to note = there will be no divination of left angle of mouth --- as it Is paralised When asked to show teeth there will be divination of rt angle. of mouth

rule out herpes zoster oticus. it is Bell's palsy. rule out mastoid/ parotid abscess. get CT head done. start wysolone 60 mg/ day, acyclovir 400 mg five times a day, vit b 6, 12, artificial tear drops.

Facial nerve palsy Left sided. Inv. Blood sugar, Thyroid profile, Left ear exam. for herpes zoster.

Most probably a case of Bells palsy.. Watch out for Bell's phenomenon... Rx.. Steroid acyclovir and eye patch to prevent exposure keratitis...

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