Acute Facial Palsy Case 1

A 53-year-old man presents to the ED with a four hour history of a left-sided facial weakness. He is convinced that he has had a stroke.

The triage nurse documents a series of routine observations that are all within normal limits. The nurse also takes a history from the patient and documents a number of additional symptoms.

Select the symptom for the corresponding branch of the facial nerve which is responsible for that problem.

You then start to see the patient and take a more detailed history and examine him. You notice an obvious weakness to the muscles of the left side of his face. How do you differentiate between an upper and lower motor neuron facial nerve lesion?

You then conduct a further examination of the patient to look for other abnormal findings that may indicate a cause for the facial weakness.

Select the likely diagnosis for the appropriate examination finding.