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Acute HIV Presenting With Unilateral Facial Nerve Paralysis: A Case Report

Cranial nerve VII palsy is one of the most common cranial nerve pathologies seen in clinical practice. In the vast majority of cases, the cause is thought to be idiopathic and is also referred to as Bell’s palsy. These cases are normally self-limiting and often treated with a short course of cortico...

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Autores principales: Kandah, Omar, Liu, Shuo, Montesano, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9943581/
https://www.ncbi.nlm.nih.gov/pubmed/36824558
http://dx.doi.org/10.7759/cureus.34062
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author Kandah, Omar
Liu, Shuo
Montesano, Peter
author_facet Kandah, Omar
Liu, Shuo
Montesano, Peter
author_sort Kandah, Omar
collection PubMed
description Cranial nerve VII palsy is one of the most common cranial nerve pathologies seen in clinical practice. In the vast majority of cases, the cause is thought to be idiopathic and is also referred to as Bell’s palsy. These cases are normally self-limiting and often treated with a short course of corticosteroids for symptom management. However, prompt work-up and diagnosis are crucial, as non-idiopathic causes can often be life-altering and necessitate prompt intervention. Here, we report a unique case of a 43-year-old immigrant male who presented to the emergency department with a three-day history of worsening facial droop and slurred speech, with associated facial pain, headaches, and dizziness for the previous week. On exam, there was stark right facial weakness involving both the upper and lower portions of the face with no sensory deficits. The patient’s right eye was erythematous and painful, with no ability to fully open or close the right eyelid. The initial workup showed minor transaminitis with pancytopenia. A thorough workup was initiated, and all testing and serology were normal, with the exception of initial HIV screening. This was then followed by polymerase chain reaction (PCR) and viral load testing, which confirmed a new diagnosis of acute HIV infection presenting with unilateral CN VII palsy. In this report, we discuss the etiology, clinical features, differentials, and treatment options for facial nerve paralysis, along with the subtle connection to acute HIV infection.
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spelling pubmed-99435812023-02-22 Acute HIV Presenting With Unilateral Facial Nerve Paralysis: A Case Report Kandah, Omar Liu, Shuo Montesano, Peter Cureus Internal Medicine Cranial nerve VII palsy is one of the most common cranial nerve pathologies seen in clinical practice. In the vast majority of cases, the cause is thought to be idiopathic and is also referred to as Bell’s palsy. These cases are normally self-limiting and often treated with a short course of corticosteroids for symptom management. However, prompt work-up and diagnosis are crucial, as non-idiopathic causes can often be life-altering and necessitate prompt intervention. Here, we report a unique case of a 43-year-old immigrant male who presented to the emergency department with a three-day history of worsening facial droop and slurred speech, with associated facial pain, headaches, and dizziness for the previous week. On exam, there was stark right facial weakness involving both the upper and lower portions of the face with no sensory deficits. The patient’s right eye was erythematous and painful, with no ability to fully open or close the right eyelid. The initial workup showed minor transaminitis with pancytopenia. A thorough workup was initiated, and all testing and serology were normal, with the exception of initial HIV screening. This was then followed by polymerase chain reaction (PCR) and viral load testing, which confirmed a new diagnosis of acute HIV infection presenting with unilateral CN VII palsy. In this report, we discuss the etiology, clinical features, differentials, and treatment options for facial nerve paralysis, along with the subtle connection to acute HIV infection. Cureus 2023-01-22 /pmc/articles/PMC9943581/ /pubmed/36824558 http://dx.doi.org/10.7759/cureus.34062 Text en Copyright © 2023, Kandah et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Kandah, Omar
Liu, Shuo
Montesano, Peter
Acute HIV Presenting With Unilateral Facial Nerve Paralysis: A Case Report
title Acute HIV Presenting With Unilateral Facial Nerve Paralysis: A Case Report
title_full Acute HIV Presenting With Unilateral Facial Nerve Paralysis: A Case Report
title_fullStr Acute HIV Presenting With Unilateral Facial Nerve Paralysis: A Case Report
title_full_unstemmed Acute HIV Presenting With Unilateral Facial Nerve Paralysis: A Case Report
title_short Acute HIV Presenting With Unilateral Facial Nerve Paralysis: A Case Report
title_sort acute hiv presenting with unilateral facial nerve paralysis: a case report
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9943581/
https://www.ncbi.nlm.nih.gov/pubmed/36824558
http://dx.doi.org/10.7759/cureus.34062
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