An elderly patient presents a facial droopiness with some new hearing loss.
Analysis
Here there is the presence of facial drooping of the left side of the face. In addition, there was both SPK and facial numbness in the V1 and V2 distribution. The hearing loss was confirmed. The patient also started to ataxia, vertigo and falls. Imaging showed lytic lesions of the skull base.
The patient was diagnosed with metastatic lesions with a presumed primary lung carcinoma.
The patient was also noted to have an abdominal mass, multiple bone mets and lung lesions.
In this 15 min. video featuring Dr. Gabriela Lahaie Luna, Fellow, University of Pennsylvania and CHOP, we'll review:
- Review the anatomy of the facial nerve
- The causes of facial nerve palsy
- When to consider a malignant cause of a cranial nerve palsy
Clinical Tip
In a patient with a facial nerve palsy, always look for associated other cranial neuropathies (including CN 5, and 8).
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