Welcome back, clinical problem solvers.

Just a reminder that this podcast is intended to be purely educational and is not meant as medical advice.

Any patient information has been modified to protect the patient's identity.

The views expressed in this podcast do not necessarily reflect the views of our employers.

Enjoy the show.

Thank you. not necessarily reflect the views of our employers. Enjoy the show. So the chief complaint is 32-year-old female presenting with left facial numbness for five days. Left facial numbness for five days.

Excellent. Drehan, just a few months, you might see a patient like this. What would start coming to

mind for you? Left facial numbness for five days? Well, it's kind of sub-acute. I would not immediately

think of something vascular because it's been a few days,

it's been almost a week. I would maybe ask her more about triggers, ask her what started,

because there may be more of like a facial paralysis component triggered by an infection, for example.

So, yes, those are my first thoughts. Like just

this up acute nature, I would just start by collecting more history and understanding how it,

how it all started. Great. And we'll get some of that information soon. Just for now, Andrea,

you said this is not sudden, so it's very unlikely to be a stroke, although we don't know yet

from the history. Maybe it started suddenly five days ago and has been static, so I want to determine that.

What other kinds of things would you be thinking about, Andrea, if it turns out this is not sudden,

but has been evolving or worsening for five days?

What other kinds of things would you think about related to that time course?

Well, the first thing that I thought about was a bell's palsy, as I mentioned, a facial weakness

or paralysis that could be triggered by an infection, for example.

Another thing I could think of that is associated with like brief episodes of facial numbness

...