Q patients data -age-45, weight -60,height-54" medical history-patient was apparently- alright 12 days back when developed pain behind right ear it was not severe but mild bearable and continuous then followed by small vesicle near right nostril there is no fever ,no headache ,patient rushed to the m.d physician with above complaints he advised E.N.T opinion .again patient visited to E.N.T specialist he has given supportive and symptomatic treatment then again advised neuro physician opinion. patient visited the same he advised MRI brain and whole spine it was normal .in between developed severe generalised weakness with drooping eyelids and billateral facial palsy patient is not able to walk more than 5 steps if she has been trying than exhausted extremely and she needs immediatly rest. associated problems difficulty in chewing, difficulty in facial expressions and protrusion of lower lip during walk .she is now hospitalised and her vitals are b.p-160/100 pulse 80,temperature normal.r/r 20 r/s -b/l clear, a/e bilateral equal,cvs -s1 s2+,rhythemic ,p/a soft,bowel sound present ,cns- conscious,oriented ,slurred speech muscle power normal,reflexes normal muscular tone normal planters flexer, vision normal acuity normal fundus normal no diplopia no strabismus. Past medical history - patient is known case of HT , she has operated for goiter thyroid in 1998 ,she also hospitalized for rashes all over body ,etching and diagnosed food allergy (s.ige positive) in 2011. Still patient under evaluation for diagnosis.
As the history suggests, this may be related with nerves. This is usually seen as a result of trauma, damage, or inflammation of one of the facial nerves. This can occur because of facial or head trauma or inflammation, swelling, or compression of the nerve. Researchers arent sure what causes the nerve to become damaged in those instances when physical trauma is ruled out. Most think a virus is to blame, such as the herpes simplex (cold sore) virus or viral meningitis; however, the condition has also been linked to Lyme disease, tumors, high blood pressure, sarcoidosis, headaches, the flu, and chronic middle ear infections. So this may have made the diagnosis difficult in her case.The treatment along with the symptomatic and systemic medicines includes antiviral medication and pain relievers. Eye protection, relaxation techniques, acupuncture, electrical stimulation, biofeedback, physical therapy, and vitamin therapy.