Chief Complaint: Facial weakness
History of Present Illness
A 38 year-old female presents to the emergency department stating that over the past 36 hours, she has developed right sided facial weakness (Links to an external site.)Links to an external site. and drooping, an associated right sided ear and jaw ache and inability to close her right eye. She is unable to move both the upper and lower side of her face. She does report a history of an upper respiratory infection about 10 days ago.
Past Medical History
Hypothyroidism
Current Meds
Synthroid 75mcg once daily
Family History
Father, Hypertension and Hyperlipidemia
Mother, Hypothyroidism
Brother, Hypertension
Review of Symptoms
Denies any chest pain, shortness of breath, dizziness or headache. All other systems reviewed and found negative except as stated in HPI.
Physical Examination
Vital Signs; T 98.8, BP 136/74, RR 18, HR 76, O2 98% RA
General: Well developed and well appearing
Case Study Discussion – Part I:
Answer the following and post your response in the Case Study Part I by creating your own initial thread.
Identify three conditions that you would consider in your differential diagnosis, with the most likely condition listed first. Provide rationale for each differential with supporting evidence from the case study.
What further history, further examination, and diagnostic studies should be considered in order to explore your differential diagnosis and confirm your suspicions?
The three conditions that can be suspected from the above case history include :
1. Facial palsy
2. Bells palsy
3. Stroke
The above three conditions are most suspected because the patient is showing signs of facial muscle weakness and paralysis which indicates a neurological condition involving the facial nerve and associated brain structures.
Further investigations include :
1. Facial muscle MMT
2. CT scan of brain
3. MRI of brain
4. NCV for facial nerve
5. EMG
6. Ultrasound doppler
7. Cerebral angiography
8. blood tests
9. ECG
Chief Complaint: Facial weakness History of Present Illness A 38 year-old female presents to the emergency...
Week 3 Case Study Chief Complaint: Facial weakness History of Present Illness A 38 year-old female presents to the emergency department stating that over the past 36 hours, she has developed right sided facial weakness (Links to an external site.)Links to an external site. and drooping, an associated right sided ear and jaw ache and inability to close her right eye. She is unable to move both the upper and lower side of her face. She does report a history...
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