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Flashcards in Bell's Palsy Deck (39):
1

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

Equal

2

What conditions predispose patients to Bell's palsy?

-Pregnancy
-DM

3

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

True

4

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

Lyme's disease

5

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

Sudden

6

True or false: there is usually associated ear pathology

False

7

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

Other signs of CNS pathology

8

What are the supposed etiologies of Bell's palsy?

-viral
-Nerve ischemia
-Autoimmune

9

What are the viruses associated with Bell's palsy?

-HSV
-EBV

10

What is the pathophysiology of Bell's palsy?

Neuropathy

11

What foramen does CN VII come out of?

Stylomastoid foramen

12

What are the branches of CN VII?

-Temporal
-Zygomatic
-Buccal
-Masseter
-Cervical

13

What is the narrowest part of the facial nerve path?

Internal Genu of the internal auditory meatus

14

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

MRI

15

What is the treatment for Bell's palsy?

High dose steroids and antivirals

16

What are major sequelae of Bell's palsy?

-Corneal abrasion
-Alteration of taste
-Synkinesis

17

CN VII provides what part of taste on the tongue?

Anterior 2/3

18

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

CN IX

19

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

True

20

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

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

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

True

22

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

True

23

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

Vesicles in the ear with Ramsay Hunt syndrome

24

What are acoustic neuromas?

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

25

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

NF2
Merlin

26

True or false: most acoustic neuromas are bilateral

False--95% are unilateral

27

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

-Sudden or gradual hearing loss
-New onset tinnitus
-New onset vertigo
-Facial palsy or pain

28

What is the best screening test for an acoustic neuroma?

Hearing test

29

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

MRI with gadolinium

30

What is the treatment for acoustic neuromas?

Surgery

31

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

True

32

Where do acoustic neuromas usually grow?

-Level of the internal auditory canal
-Cerebellopontine angle

33

How fast (relatively) do acoustic neuromas usually grow?

Slowly

34

What are glomus tumors (paragangliomas)?

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

35

What are the s/sx of glomus tumors?

Pulsatile tinnitus

36

How can you check for a paraganglioma?

Listen to the ear with a stethoscope

37

Recurring facial nerve paralysis is suspicious for what?

Facial nerve neuromas

38

Where are cholesterol granulomas found?

Petrous apex, associated with hemorrhage into air cells

39

Hearing should be above what decibel?

20