A 42-year-old man attends the emergency department complaining of weakness down one side of his face. Over the past 2 days, he has noticed an altered taste sensation and pain in and around the ear on the same side. There is no history of trauma. He has not noticed any discharge from the ear and there is no limb weakness. He is a known asthmatic and he suffers from depression. He has recently given up smoking. He is currently using salbutamol and becotide inhalers and takes paroxetine 20 mg od.
He has no known allergies. Examination Cardiovascular, respiratory and abdominal examinations are normal. His gait and balance are normal. Neurology of the upper and lower limbs is unremarkable. Face examination revealed some asymmetry, which is more obvious when you ask the patient to smile. When the patient was asked to show his teeth, the right side of the face was drooping. On raising his…
