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Case 21 

Case 21
Chapter:
Case 21
Author(s):

Sarah T Pendlebury

, Philip Anslow

, and Peter M Rothwell

DOI:
10.1093/med/9780192631626.003.0021
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date: 25 June 2019

A 22-year-old woman complained of having difficulty eating, and of closing her right eye. There was a history of otitis media 3 weeks previously for which she had received antibiotics. On examination, there was a complete right lower motor neuron VII palsy and she was given steroids and aciclovir for presumptive Bell’s palsy. Over the next 4 days she developed bilateral hearing loss accompanied by severe right frontal and periorbital pain, worse on coughing. The following day she had double vision on looking to the right. Examination confirmed altered sensation over the V1 and V2 distribution, a right VI nerve palsy, right lower motor neuron VII and bilateral sensorineural hearing loss.

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