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Bell palsy versus stroke — ABEM Board MCQ

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EasyNeurological emergenciesBell palsy versus strokeABEM Board

A 42-year-old man arrives with right facial weakness noticed on waking. Triage acuity is ESI 3; BP 126/78 mm Hg, HR 76/min. He cannot wrinkle the right forehead, close the right eye, or smile on the right. Limb strength, speech, and coordination are normal. Which of the following is the most appropriate disposition?

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Correct answer: C — Discharge with eye protection, corticosteroids, and close follow-up

Isolated complete unilateral facial paralysis including the forehead is consistent with Bell palsy; eye protection and steroids are appropriate when no central features are present.

Reference: AAO-HNS Bell palsy guideline