Four consecutive pictures of a patient in 1 hour. Diagnosis?

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Dx :- Faucal diphtheria, caused airway obstruction. It's mostly due to mitis variety. D / D :- Tetanus.

Despite the best answer being selected as risus sardonicus, please do note everyone who answered the pictures that the patient indeed came with myasthenic crisis. This was the neostigmine test done on stabilisation. He's been started on pyridostigmine and is doing well

Sir! Agreed your diagnosis.. but how to explain your serial changes in eyes in these serial pictures. First eyes eyes are closed then after giving neostigmine upper. eyelids paralyzed.. please explain..
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Response to neostigmine test

Sir muscle weakness is not appreciable from the photo. Is there such a history?
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Tetanus possible Risus sardonicus , facial grimaces may be due to resp. Dumping

OPHTHALMOPLEGIA PT DOES NOR APPEAR TO BE STABLE HAS NASOGASTRIC TUBE WHAT IS REPORT OF MRI RAIN TO BE REVIEW ED BY NEUROLOGIST

Risus sardonicus or rictus grin is a highly characteristic, abnormal, sustained spasm of the facial muscles that appears to produce grinning. It is most often observed as a sign of tetanus. It can also be caused by poisoning with strychnine, or in Wilson's disease.

How are you explaining the bilateral facial palsy with this theory?
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? Tetanus ? Oculogyric Crisis ? Seizure

Tetanus

Tetanus,lock jaw with rhisus Sardonicus

Y the bl facial weakness
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Bifacial paresis, most likely GBS, what is the NCV report and CSF test.

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