A 65-year-old man presents to your clinic with a chief complaint of progressive difficulty in swallowing over the past 3 months. Upon further inquiry, he reports a weight loss of approximately 2 kilograms, which he attributes to decreased food intake. He denies any pain with swallowing or regurgitation of food. During the consultation, you observe a change in his voice quality. What is the probable diagnosis?
A 70-year-old man visits the GP clinic after waking up unable to move the left side of his face. His wife observed slight drooling from the left side and difficulty fully closing his left eyelid. He has no significant medical history. Which symptom is most consistent with Bell’s palsy?
A 30 year old man comes to the clinic complaining of anorexia, feverishness, and vertigo that have been going on for four days. He reports having difficulty balancing and staying upright when walking, as well as experiencing mild vertigo episodes lasting 10-20 minutes at a time. His hearing is unaffected. During the examination, some cervical lymphadenopathy is observed, but otherwise, there are no notable findings. What is the probable diagnosis?
A 53-year-old man presents with a 3-days-history of left-sided facial droop. He denies any associated facial pain, eye symptoms or neurological symptoms. There is no history of trauma.
Upon examination, there is a unilateral facial weakness involving the entire left side of his face. He is unable to fully close his left eye. The remainder of the neurological examination is unremarkable. There are no rashes on his ears, face or mouth. His neck is soft with no palpable swellings or lymphadenopathy.
What is the most appropriate course of action for managing this patient?
You have a telephone consultation with a 39-year old male patient who has paralysis on the left-hand side of his face. It started 2 days ago with left sided facial and ear pain. The pain is now very severe and causing him considerable discomfort. He is unable to move his left forehead, close the left eye or move the left-hand side of his mouth. He is normally fit and well.
You suspect that he has a Bell’s palsy and arrange to see him in your clinic that afternoon to examine him.
Which statement below regarding Bell’s palsy is correct?
A 42-year-old female patient complains of left-sided facial muscle weakness that has been present for 72 hours. She has no known medical conditions and is not taking any medications. The symptoms started during a camping trip, and she believes that her delay in seeking medical attention may have contributed to the severity of her condition. Upon examination, she exhibits left-sided facial nerve palsy with no forehead movement. All other cranial nerves appear normal, and there are no neurological deficits in her upper or lower limbs. What is the best course of action for managing this patient’s condition?
A 22-month-old girl comes in with mild unilateral ear pain that started yesterday. She keeps tugging at her left ear. There is no discharge. She has no rashes and is still eating and drinking normally. She has not had any fevers.
During the examination, her temperature is 36.9ºC and her pulse is 105 beats per minute. She appears to be in good health. Both of her ears appear to be normal.
What is the best course of action for treatment?
A 42-year-old woman presents to her GP for a follow-up appointment. She was diagnosed with Bell’s palsy three weeks ago after experiencing left-sided facial weakness. The GP prescribed a 10-day course of oral prednisolone and provided eye care advice. However, the patient reports no improvement in her symptoms since then.
During the examination, the patient appears healthy but still has left-sided facial weakness without forehead sparing. The rest of her cranial nerve examination is normal, and there is no indication of middle ear disease.
What would be the most appropriate next step?
A mother whose 12-year-old son had a history of glue ear when younger requests a copy of his medical records from the practice manager. Which of the following statements regarding access to medical records is not accurate?
A 27-year-old patient comes in for an emergency appointment reporting left-sided ear pain for the past two days. Upon waking up today, she noticed that her face was drooping on the left side and she was unable to fully close her left eye. Based on these symptoms, you suspect a diagnosis of Bell’s Palsy. If you were to ask the patient to raise her left eyebrow, what would you expect to find and why?