Author: Nneoma Ekweozor, Ijaz Ali, Vikram Baicher / Editor: Nick Tilbury / Codes: EC4, EC8, EP5, SLO5 / Published: 16/10/2024
A 15-year-old boy presents to the Emergency Department reporting that the right side of his face “face isn’t moving properly”. His mum tells you he had a single episode of bleeding from his right ear approximately 12 hours earlier. He has also been suffering with earache for the previous 4 days. He is otherwise fit and well. There is no history of fever, trauma or foreign body insertion.
He isn’t on any regular medications, has no allergies and his vaccines are up to date.
On your assessment, he appears well in himself, his observations are as follows:
- Respiratory rate – 20/min
- SpO2 – 99% on air
- Heart rate – 78 BPM
- Blood pressure – 121/74
- Temperature – 37.2
He appears to have complete paralysis of the right side of his face, including the forehead (House-Brackmann score VI).
In his right ear you note crusted up blood, with a bulging tympanic membrane, he has no vesicles, no mastoid redness or tenderness and no rashes. His left ear is unremarkable.
He has normal tone and power in all 4 limbs and is mobilising normally.
Module Content
Acute Facial Palsy
This session looks at the assessment and management of acute facial palsy.
Bell’s Palsy in Children
Bell's palsy is a relatively uncommon condition presenting to primary care. Despite a benign course for most children with Bell's palsy, there are a number of serious causes of facial paralysis which can be easily missed.
The Droopy Dribbler: Paediatric Presentations of Bell’s Palsy
Paediatric cases of Bell's Palsy are relatively uncommon (6.1/100000 in the age range 1-15 (1)); understandably, witnessing a rapidly developing facial asymmetry in a child will cause worried parents/guardians to rush to see a doctor
4 Comments
Nice case
nice case
👍
very interesting case