Editorial
14 July 2023
Your 66-year-old patient will see you at 10 a.m. this morning after waking up this morning with a crooked mouth. He is otherwise healthy. An elevated glucose level or high blood pressure has never been diagnosed. He denies a tick bite. There are no complaints from his ears, but sounds seem to be slightly louder on the right.
Research
According to the House-Brackmann (HB) Grading System, you score a grade IV right, because he just can’t close his right eye with difficulty. In the photo you can see the effect of maximum effort on the mouth. At rest there is no asymmetry in the face and the facial tone is normal. There are no abnormalities in either ear. There are no blisters visible in the ear canal or on the auricle. The tuning fork examination is normal.
You come to the conclusion that your patient has right-sided idiopathic peripheral facial palsy (IPAV).
What is your diagnosis?
What does your treatment consist of (following the guideline)?
You do not give any medication, do not refer to an ENT specialist, but do prescribe a watch bandage 2dd 25 mg prednisone for 10 days 2dd 25 mg prednisone for 10 days and 3dd 1000 mg valaciclovir for 1 week 3dd 1000 mg valaciclovir for 1 week Refer to ENT doctor for possible surgical decompression
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2023-07-14 07:02:16
#Case #man #crooked #mouth #DOQ
