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Answers: 2007 series -  October 2, 2007 Lecture 13 of 52  NEXT»

To see views enlarged, click on the individual pictures...

This 36-year-old woman had surgery for a brain stem vascular lesion.  After surgery she appears as shown in the pictures.  She looks to the left with right face turn to avoid diplopia.  Abduction of the right eye is limited.  She has weakness of the right lower and upper face and is unable to close the lids of the right eye.

1.  The most likely diagnosis in this case is:   
 

e -- none of the above

This patient has a lower and upper lid facial weakness.  This indicates a brain stem lesion.  When the seventh nerve palsy is in the brain stem it produces an ipsilateral  palsy.  Supranuclear lesions affecting the seventh nerve involve the lower face and are likely to spare the upper face.  They are also contralateral.

 

2.  Bellís palsy is:  
 

e -- all of the above

All of the options listed are characteristics of Bellís palsy

 

3.  The most important initial help for this patient immediately is: 
 

a -- provide lubrication for the right eye to protect the cornea

Since the lids cannot fully protect the right eye because of weakness of the orbcicularis oculi, lubricating drops or ointment are very important to protect the cornea.

 

 


Lecture 13 of 52 «Previous Lecture   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52    Next»