Bell’s Palsy in Children Case 1

A 6-year-old girl presents to the ED accompanied by her mother with a history of 1 day of drooping on one side of her face noticed by her mother.

What information is critical to elicit at this stage of your assessment?

See if you can list at least eight pieces of information here.

History reveals no important associated symptoms and no causes for concern.

How would you assess this child if she presented to you in the ED? 

See if you can list at least five things you might do here.

Examination proves to be normal, identifying no worrying features.

What further tests would you do on this patient in the ED?

What is your current differential diagnosis?

No further tests were carried out at the time given the features identified on history and examination.

How would you manage this child?

The child was prescribed a course of prednisolone 1 mg/ kg orally daily for 10 days.

How should follow-up be arranged?

The child was prescribed a course of prednisolone 1mg/kg orally daily for 10 days. Follow-up was arranged for 3 weeks time for a review. An advice card was given outlining what to expect and features to look out for and when to come back sooner if concerned.

When giving discharge advice, further medical advice should be sought for which of the following symptoms?