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.
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 head.to rule out intracranial pathology as eye is spared
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 stretch..is it trigeminal 2.looks like facial but never label as bells without ruling out other treatable causes
Cases that would interest you
- Login to View the image
pt.aged 27 yrs. suddenly developed this problem, since 4days spot Dx. Please
Dr. Chandarlal Udasi7 Likes47 Answers - Login to View the image
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?
Dr. Ramesh Rajendiran12 Likes43 Answers - Login to View the image
7 yr old boy presented with h/o inability to close Rt eyelid & features of Rt sided facial palsy since 4 days and h/o chicken pox since one day. Mild fever since one day. D/D and mx
Dr. Angel Bennet3 Likes23 Answers - Login to View the image
cane with present complaint as u c.past h/o water like bubbles on her face 5 to 6 months back no treatment received.not a diabetic r hypertensive.pain on her rit half of face with numbness.-bells palsy . treatment options.?
Dr. Jayanth Chilakala2 Likes29 Answers - Login to View the image
A male 45yrs has mild grade fever running nose nausea loose motion 3to5/day off and on Mild cough since last 5to 7days. Cbc urine exam bs blood urea serum creatinine and liver function all are within normal limits. Taken tt for viral fever .responded well with tt. On 5th day devloped inability to open lt eye and tricling of saliva and water from lt side of mouth. Pictures are enclosed below.kindly heighlight over complication and tt plan and ?cause.
Dr. M R Chhipa2 Likes19 Answers
3 Likes