QuestionSBA
QuestionChoice
Bell's palsy is an idiopathic syndrome affecting the facial nerve. It is characterised by: unilateral facial weakness, ear pain, hyperacusis, altered taste, and dry eyes/a dry mouth. This condition mainly affects 20-40-year-olds, and is more common in pregnant women.
10008020
a
Bell’s palsy
QuestionChoice
A traumatic injury could cause damage to the facial nerve through a basal skull fracture or following surgery. However, there are no features in the history or on examination (e.g. bruises or scars) that suggest a history of trauma in this case. It is therefore a less likely underlying diagnosis than Bell's palsy.
10008024
e
Traumatic injury
QuestionChoice
Ramsay Hunt syndrome (herpes zoster oticus) is caused by the reactivation of the varicella zoster virus in the geniculate ganglion of the seventh cranial nerve. While it can present with facial nerve palsy, this is usually preceded by ear pain and a vesicular rash around the ear. It is therefore a less likely underlying diagnosis than Bell's palsy.
10008022
c
Ramsay Hunt syndrome
QuestionChoice
Stroke often presents with new-onset unilateral facial weakness. However, on examination, this patient's presentation would be identified as an upper motor neuron facial palsy due to the presence of forehead sparing. Furthermore, the patient's young age and absence of any cardiovascular risk factors makes a stroke less likely.
10008021
b
Stroke
QuestionChoice
Horner's syndrome is characterised by ptosis and meiosis, with or without anhidrosis. It is due to an interruption of the sympathetic nerve supply to the eye. As this patient does not demonstrate meiosis or anhidrosis, Bell's palsy is the most likely explanation.
10008023
d
Horner’s syndrome
Concept
Chapter
2693
4638
Bell’s palsy
Topic
141
Neurology
14151
A 29-year-old pregnant woman is experiencing acute onset left-sided facial weakness, drooling, and a very dry left eye. She is otherwise well, has had no issues in her pregnancy so far and there is no recent history of any infections or coryzal symptoms.

She does not smoke or drink alcohol.

Which of the following is the most likely diagnosis?
a