A 20-year-old girl comes to the emergency department because she has noticed after getting up, when looking in the mirror, weakness in the right half of the face (including the forehead, closing the eyelid and smiling). She is accompanied by dysgeusia, with a sensation of metallic taste of food as well as hyperacusis and ipsilateral mastoid pain. On examination there is no evidence of strength deficits or sensory deficits in the extremities or speech or language disorders. In this case, which of the following statements is correct?
We describe a picture of typical peripheral facial paralysis, with dysgeusia, hyperacusis and mastoid pain. In this case the treatment is corticoid. The first one would not be correct because although within the age range of multiple sclerosis debut, the presentation is usually gradual over days and the nuclear involvement of the VII cranial nerve (which could simulate a peripheral facial) would not cause dysgeusia, hyperacusis or mastoid pain. In the third answer they propose us that it is a vascular picture and therefore that the facial paralysis is central, so it is discarded and the last one is not correct because most of the idiopathic peripheral facial paralysis (Bell's palsy) heal without sequelae.
The most probable diagnosis is a demyelinating plaque in the contralateral hemiprotuberance, the most necessary complementary exploration would be a cranial MRI.
Oral corticosteroids are the treatment of choice for the patient.
Intravenous fibrinolysis should be considered if the evolution time is less than 3h.
Most likely the picture is irreversible.
The first one would not be correct because although within the age range of multiple sclerosis debut, the presentation is usually gradual over days and the nuclear involvement of the VII cranial nerve (which could simulate a peripheral facial) would not cause dysgeusia, hyperacusis or mastoid pain.
We describe a picture of typical peripheral facial paralysis, with dysgeusia, hyperacusis and mastoid pain. In this case the treatment is corticoid.
In the third answer they propose us that it is a vascular picture and therefore that the facial paralysis is central, so it is discarded
the last one is not correct because most of the idiopathic peripheral facial paralysis (Bell's palsy) heal without sequelae.