HSC Section 3 - Trauma, Critical Care and Sleep Medicine

Medical Management of Acute Facial Paralysis

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consult, *BP treatment Pregnancy Bell’s Palsy Discuss risks/benefits

Amyloidosis Nonspecific, fatigue, Wegener Amyloid proteins Biopsy, Congo red stain Corticosteroids, Usually lung and kidney symptoms Necrotizing vasculitis MPO, PR3 High-dose steroids Rituxan * Lymphocytic infiltrate Salivary gland biopsy Anti-SSA, RF Immunomodulators erythematosus (SLE) Fever, rash, joint pain Vasculitis, autoantibodies ANA, depends on organ BP treatment Vasculitis Clinical diagnosis ANCA, PR3 High-dose immunomodulators, stem cell granulomatosis Sjo¨ gren syndrome Sicca syndrome-dry eyes, mouth, arthralgia Systemic lupus Immunomodulators Behc¸et disease Oral, genital ulcers, arthritis pulsed steroids raccoon eyes, all organs

Corticosteroids, plasmapharesis, immunomodulators BP treatment

anti-metabolites, immune suppressants

Immunomodulators

Synthroid, endocrine

Demyelinating disease IgG antibody IVIG, plasmapheresis* Demyelinating disease Blood test, MRI, Lumbar

*High-dose steroids

Steroids,

Metabolic Hypothyroidism Thyroid Function Tests (TFTs)

puncture, Imaging

Diagnosis of exclusion: Angiotensin converting enzyme (ACE), Chest Xray

CSF (elevated protein)

CT/MRI face, r/o other

Neuromucocutaneous granulomatous disease, fibrosis

with nonnecrotizing perivascular granulomatous infiltrate

granulomatous disease

Systemic

paresthesias, weakness

weakness, viral prodrome

edema, fissured tongue (usually asynchronous)

Sarcoidosis Any organ system - fatigue, weight loss, lung symptoms Melkersson- Rosenthal

Multiple sclerosis Fatigue, diplopia,

Guillain-Barre Ascending muscle

Recurrent FP, orofacial

syndrome

autoimmune

Systemic

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