Acute idiopathic lower motor neurone facial nerve palsy with forehead involvement.
Clinical features
- • Unilateral facial droop including forehead
- • Incomplete eye closure
- • Hyperacusis, altered taste
- • Post-auricular pain
Differential diagnosis
- • Stroke (forehead spared)
- • Ramsay Hunt syndrome (vesicles)
- • Lyme disease (bilateral)
- • Parotid tumour
- • Otitis media complication
Management
- • Prednisolone 50 mg OD × 10 days (start within 72 h)
- • Add antiviral if severe or Ramsay Hunt
- • Eye care: lubricants, taping at night
- • Refer if no recovery at 3 months
Clinical pearls
- • Forehead sparing means central lesion — image urgently
- • Corneal protection prevents permanent visual loss
Related in WardRound
Educational — verify locally.
