Case of the Week | February 19, 2021

Case of Facial Paralysis and Headache

A generally healthy 35-year-old female presents to the emergency department with right-sided facial drooping, which she noticed this morning. She is unable to close her right eye, nor can she raise her right eyebrow. She denies any known insect bites though states she works on a farm and is outside for many hours of the day. She does not wear glasses or contacts and states her vision has been normal; she has had no blurry or double vision. She states she has had some intermittent headaches over the past few weeks though otherwise has been feeling at baseline. She has not noticed any rashes and has had no ear pain. She has a normal neurologic exam and cranial nerves II-XII are intact. No other abnormalities are found on physical examination. What is the most likely diagnosis?

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