Alright shall we talk about a common condition Bell’s Palsy? RT. #neurology #medtwitter #MedEd #medstudent #neurologyresident Join me in discussing/learning/educating with #passion and #humor @WNGtweets @MedTweetorials @MadSattinJ @NinaRiggins @AaronLBerkowitz @Tracey1milligan
Q: Doc doc. This patient got a droopy left face. What next? #neurology #medtwitter #MedEd #medstudent #neurologyresident
A: Localize, splice, dice. 3 little nerve shoots in the facial canal to remember - nerve to stapezius, chorda tympani, posterior auricular. There you go: check hearing, taste, pain behind the ear.
Q: Well, doc. He got all 3. Is it Bell’s?
#neurology #medtwitter #MedEd #medstudent #neurologyresident
#neurology #medtwitter #MedEd #medstudent #neurologyresident
A: Putting cart before horse you are. Where be thy lesion? Go high not low. You got facial canal - or higher. Make sure he’s not got any symptoms or signs which implicate the pons. Any weakness or imbalance?
Q: None of those doc. So it’s Bell’s? How do you treat? #neurology #medtwitter #MedEd #medstudent #neurologyresident
A: Slow down Speedy G. All I said was it’s the facial nerve in the canal. Many causes - could be sarcoid, GBS, vasculitis, Lyme. But Bell’s most common, yes - Pred 60mg daily for a week if you catch it within 3 days.
Q: Crikey doc. He’s missed the time window. Is it like stroke when treatment is nada nada and oh dear past the time? #neurology #medtwitter #MedEd #medstudent #neurologyresident
A: Chill, mate. it’s not as if they don’t usually recover anyway. Without treatment, 70 percent recover completely by 6 months. Pred just increases it to 80 percent by 6 months.
Q: Hang on now. Thought HSV1 is the most common cause. You don’t add Valciclovir? #neurology #medtwitter #MedEd #medstudent #neurologyresident
A: Yup. HSV1, followed by VZV, CMV, EBV. Antivirals don’t confer additional benefit. #lessismore
@threadreaderapp pls unroll
