Facial Palsy
Age: years old
Gender:
HISTORY:
Presents with a - history of facial on the
Onset was
Associated symptoms: *Try using right-click for negatives*
, , , ,
, up to °, over
Contributing factors:
no history of: , , ,
EXAM:
General appearance: ,
Vital signs: , BP , HR , RR , SpO2 %, Temp °
Head: , scalp
Ears: tympanic membranes , auditory canal on , hearing
Neck: , , , c-spine
Heart: , ,
Lungs: , ,
Neurologic:
- Mental status: , oriented to , speech
- Cranial nerves:
- Strength: except for on ,
- Sensation: to on
- Reflexes: except for on ,
- Cerebellar function: , finger-nose, rapid alternating movements, heel-shin, Romberg , Dix-Hallpike
- Gait: , tandem gait, heel walk and toe walk
ASSESSMENT:
DDx: Bell's palsy, Lyme disease, herpes simplex virus reactivation, otitis media, Ramsay Hunt syndrome (herpes zoster oticus), sarcoidosis, acoustic neuroma, parotid gland tumors, stroke, TIA, HIV, diabetes mellitus, trauma to the facial nerve, multiple sclerosis
PLAN:
Investigations:
- Blood work: , , , , , ,
- CT scan of the brain
- MRI of the brain
Treatments:
- Advise that there is no signs of stroke, that condition is benign, and that most cases resolve spontaneously within a few months
-
-
- Eye care: artificial tears during the day, ointment at night, eye patch at night
- Facial exercises
Further care:
- Referral to ENT specialist within 10 days
- Referral to neurologist if central cause not ruled out
- Follow-up in
- Return if symptoms worsen, if new symptoms develop such as vision changes or severe headache, or if symptoms do not improve with treatment
- Referral to ER if difficulty swallowing, difficulty breathing, or severe headache occurs
HISTORY: Associated symptoms: EXAM: Neurologic: ASSESSMENT: PLAN: