08-04-2011, 11:55 AM
Discussion
The correct answer is A. It seems that many cases of
Bell palsy are due to reactivation of herpes simplex
virus. Other viral etiologies have been implicated as
well, including Epstein-Barr virus, CMV, and coxsackievirus.
Although answer B, tick-borne illnesses (eg
Lyme disease), may cause Bell palsy, these represent a
minority of cases. Answer C, diabetes, may put a patient
at increased risk of contracting Bell palsy, but it does
not cause the disease. Answer D is incorrect because
herpes virus is most commonly associated with Bell
palsy. Remember mycoplasma as a cause of Bell palsy.
Discussion
The correct answer is C. In a patient with Bell palsy
and weakness to eye closure, good eye care and protection
from trauma must be employed to prevent
corneal damage (remember that this patient cannot
close his right eye). The evidence for antiviral therapy
is negative; acyclovir likely doesn’t work. There
may be some slight benefit to corticosteroid. Steroids
are most likely to provide a benefit if started within a
few days after the onset of symptoms. Our patient is
1 week out from the onset of symptoms
Discussion
The correct answer is C. Most patients will recover,
but it may take months. Patients with complete paralysis
are more likely to have persistent symptoms,
whereas those with partial paralysis usually recover
more quickly and completely
The correct answer is A. It seems that many cases of
Bell palsy are due to reactivation of herpes simplex
virus. Other viral etiologies have been implicated as
well, including Epstein-Barr virus, CMV, and coxsackievirus.
Although answer B, tick-borne illnesses (eg
Lyme disease), may cause Bell palsy, these represent a
minority of cases. Answer C, diabetes, may put a patient
at increased risk of contracting Bell palsy, but it does
not cause the disease. Answer D is incorrect because
herpes virus is most commonly associated with Bell
palsy. Remember mycoplasma as a cause of Bell palsy.
Discussion
The correct answer is C. In a patient with Bell palsy
and weakness to eye closure, good eye care and protection
from trauma must be employed to prevent
corneal damage (remember that this patient cannot
close his right eye). The evidence for antiviral therapy
is negative; acyclovir likely doesn’t work. There
may be some slight benefit to corticosteroid. Steroids
are most likely to provide a benefit if started within a
few days after the onset of symptoms. Our patient is
1 week out from the onset of symptoms
Discussion
The correct answer is C. Most patients will recover,
but it may take months. Patients with complete paralysis
are more likely to have persistent symptoms,
whereas those with partial paralysis usually recover
more quickly and completely