Facial palsy and neuropathy point to a serious syndrome
A patient's symptoms flag a serious diagnosis to his GP, whose advocacy leads to appropriate diagnosis and management
Jack is a 23-year-old retail worker who presents to his GP with five days of left facial palsy, with a working diagnosis of Bell’s palsy.
He describes associated recent and repeated viral symptoms and intermittent dry cough, myalgia and fatigue. COVID-19 and influenza RATs are negative
He initially attended a private emergency care centre five nights ago and was prescribed oral valaciclovir 1g tds and oral prednisone 75mg daily for five days, for Bell’s palsy.
He was no better after four days of treatment, so then presented to the local tertiary ED.
