Neuro

Question 1

Bell’s palsy typically symptoms?
Classical presenting symptom of Ramsay’s hunt syndrome?

Answer 1

This is an entirely typical history of Bell’s palsy with acute (but not sudden) onset unilateral facial weakness. Associated features such prodromal postauricular otalgia, altered taste, dry eyes/mouth, and hyperacusis are also characteristic

Question 2

Bell’s palsy treatment?

Answer 2

Unilateral weakness in the distribution of the facial nerve is most likely Bell’s Palsy, for which you would give Prednisolone if seen within 72 hours.

Even though there is no mention of a rash on inspection, Otoscopy is useful to look for Ramsay Hunt Syndrome. In Ramsay Hunt syndrome, the vesicular rash is typically around the external ear, but additional Otoscopy is required to help exclude it

Question 3

First line treatment for tonic-clonic seizures?

Answer 3

Lamotrigine (or Leviteracetam) is the first-line treatment of tonic-clonic seizures, especially in a female of reproductive age, where the teratogenic side-effects of Sodium Valproate, the other first-line treatment, make the latter option less suitable