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Specialty Medicine > Bell's Palsy > Flashcards

Bell's Palsy Flashcards

1
Q

Which gender is more commonly affected with Bell’s palsy?

A

Equal

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2
Q

What conditions predispose patients to Bell’s palsy?

A
  • Pregnancy

- DM

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3
Q

True or false: Bell’s palsy is a diagnosis of exclusion

A

True

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4
Q

What is the infectious disease that is associated with Bell’s palsy?

A

Lyme’s disease

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5
Q

Is Bell’s palsy generally a slow or gradual onset?

A

Sudden

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6
Q

True or false: there is usually associated ear pathology

A

False

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7
Q

What must be r/o to diagnose Bell’s palsy?

A

Other signs of CNS pathology

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8
Q

What are the supposed etiologies of Bell’s palsy?

A
  • viral
  • Nerve ischemia
  • Autoimmune
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9
Q

What are the viruses associated with Bell’s palsy?

A
  • HSV

- EBV

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10
Q

What is the pathophysiology of Bell’s palsy?

A

Neuropathy

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11
Q

What foramen does CN VII come out of?

A

Stylomastoid foramen

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12
Q

What are the branches of CN VII?

A
  • Temporal
  • Zygomatic
  • Buccal
  • Masseter
  • Cervical
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13
Q

What is the narrowest part of the facial nerve path?

A

Internal Genu of the internal auditory meatus

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14
Q

What is the imaging modality of choice for diagnosing Bell’s palsy (assuming you are not suspecting a brain hemorrhage)?

A

MRI

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15
Q

What is the treatment for Bell’s palsy?

A

High dose steroids and antivirals

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16
Q

What are major sequelae of Bell’s palsy?

A
  • Corneal abrasion
  • Alteration of taste
  • Synkinesis
17
Q

CN VII provides what part of taste on the tongue?

A

Anterior 2/3

18
Q

What provides taste to the posterior 1/3 of the tongue?

A

CN IX

19
Q

True or false: most of the time, Bell’s palsy is a self limited disease

A

True

20
Q

What is Ramsay Hunt syndrome? What is the classic triad of symptoms?

A

Reactivation syndrome of herpes zoster in the geniculate ganglion. It has variable presentation which may include a lower motor neuron lesion of the facial nerve, deafness, vertigo, and pain.

-A triad of ipsilateral facial paralysis, ear pain, and vesicles in the auditory canal and auricle is typical for Ramsay Hunt Type II.

21
Q

True or false: full recovery with Ramsay Hunt syndrome is not as likely as Bell’s palsy

A

True

22
Q

True or false: the s/sx of Ramsay-Hunt syndrome are often more severe than that of Bell’s palsy

A

True

23
Q

How can you differentiate Bell’s palsy from Ramsay Hunt syndrome?

A

Vesicles in the ear with Ramsay Hunt syndrome

24
Q

What are acoustic neuromas?

A

Slow growing, benign tumor of the myelin sheath of the vestibulocochlear nerve

25
Q

Bilateral acoustic neuromas = what disease? What is the gene that is mutated with this?

A

NF2

Merlin

26
Q

True or false: most acoustic neuromas are bilateral

A

False–95% are unilateral

27
Q

What are the s/sx of acoustic neuromas? (4)

A
  • Sudden or gradual hearing loss
  • New onset tinnitus
  • New onset vertigo
  • Facial palsy or pain
28
Q

What is the best screening test for an acoustic neuroma?

A

Hearing test

29
Q

What is the imaging modality of choice to diagnose acoustic neuromas?

A

MRI with gadolinium

30
Q

What is the treatment for acoustic neuromas?

A

Surgery

31
Q

True or false: once hearing loss is had with acoustic neuromas, it is irreversible

A

True

32
Q

Where do acoustic neuromas usually grow?

A
  • Level of the internal auditory canal

- Cerebellopontine angle

33
Q

How fast (relatively) do acoustic neuromas usually grow?

A

Slowly

34
Q

What are glomus tumors (paragangliomas)?

A

Benign neuroendocrine tumor of neural crest cells, that arise in the head/neck/thoracic region.

35
Q

What are the s/sx of glomus tumors?

A

Pulsatile tinnitus

36
Q

How can you check for a paraganglioma?

A

Listen to the ear with a stethoscope

37
Q

Recurring facial nerve paralysis is suspicious for what?

A

Facial nerve neuromas

38
Q

Where are cholesterol granulomas found?

A

Petrous apex, associated with hemorrhage into air cells

39
Q

Hearing should be above what decibel?

A

20

Specialty Medicine (36 decks)

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