Pt age 22 years . Complaints of deviated lip during speaking of OM since 4 days ago. He also complaints of pain in occipital area and stretch around left eye. Dx and Rx



Details mentioned are not sufficient to diagnose facial palsy. Ask the patient to show his teeth/smile and look for asymmetry. Ask the patient to close eyes and look for Bells phenomenon. If he is unable to close one eye, its LMN- Bells. If only lower half of face is involved, its UMN. If he is able to do all activities correctly and there is only lip deviation during speaking, it is likely to be action dystonia, which I think is more likely looking at the picture, although video will help better. Another possibility to keep in mind- psychogenic, after ruling out all causes.

I have video doc but how I can load here

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sparing of orbicularis occuli, but involving orb-oris is suggesting supra nuclear facial palsy. it's not bell's palsy which is idiopathic complete(infra nuclear) facial palsy. so rule out intra cranial pathology starting with a CT brain with contrast.

Bell palsy. Needs a CT brain to r/o an intracranial pathology, followed by strapping and electrical stimulation.

Most common cause is left side LMN facial palsy. Stretch as he is not able to close his left eye. Its idiopathic. Now a days no role of antiviral like acyclovir so start wysolone 1to 1.5 mg per kg body wt for 7 days and better to taper along with physiotherapy and consult eue surgeon as he may develope corneal ulcer if eyes not closed while sleeping where he would be advised eye padding. Inv like blood sugar should be done and BP monitoring. No need for CT right at this moment,only if suspecting secoudary cause of Bells palsy

Facial palsy left, rule out middle ear infections, advised MRI brain, treat accordingly.

Looks like Left side Bell's palsy. As his also complaints of headaches, get CT scan head to rule out intracranial pathology.

Left sided bells palsy . Advised CECT rule out intracranial pathology as eye is spared

bells is idiopathic , total or lmn type f palsy eye is involved in it unlike here.

bells palsy

a case of bell 'developed during course of tt so rx accordingly with acyclovir 800mg5hrly for 7 days with paracetamol & supportive systemic steroids orally in tapered manner

1.eye it trigeminal 2.looks like facial but never label as bells without ruling out other treatable causes

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