Case

A 34 year old patient comes to your clinic with paralysis of the left side of their face. You notice that their facial anatomy is asymmetrical with the right side showing facial expressions and the left side showing no movement or expression. The patient is drooling and is having trouble talking. When taking the patient history, they also report diminished food flavor and had parotid gland surgery in the last week as well as starting a new migraine medication along with recovering from the flu. A neurological assessment shows no other cranial nerve neuropathies.

Question 2/2 - What is your plan for this patient?

Click on your selected option(s) below  (correct = 2, over-thinking = 3+)

Case Complete

Correct. A neurology specialty consult is warranted.

Incorrect. Given the proximity to the parotid surgery inflammation is likely, which will resolve with time. Thus, immediate surgery is not warranted.

Incorrect. A major second surgery is not going to affect the paralysis and may make it worse to try facelifts or other cosmetic based procedures at this time.

Correct! There are exercises to strengthen facial expression muscles, to encourage reinnervation of muscles with residual nerve fibers (should there have been direct damage to fibers).

Correct! This is a 'wait and see' situation where monitoring recovery as post-surgical inflammation decreases, then reassess if the paralysis persists. 

Incorrect. Face transplants suffer from neuropathy as well, and such an outcome for a post-surgery recovery is somewhat extreme.