History for Peripheral 7th Nerve Palsy

Below is a template of questions to ask during the history portion of a patient interview in the initial consultation or subsequent followup notes. The template can be carried forward in all future notes.

History:

  • Symptom Onset: Time of onset

  • Progression: Slowly progressive, static, waxing and waning

  • Preceding event(s): (ex. dental procedure, trauma, surgery, ear infection, tick bite (to assess risk for lyme disease) etc)

  • Known intracranial pathology: (Primary CNS malignancy, metastatic disease, meningitis, etc.)

  • Associated Symptoms (to assess location of dysfunction and narrow differential):

    • Pain behind the ear

    • Hyperacusis

    • Hypesthesia

    • Reduced taste

    • Vesicular eruption in the external auditory canal or oropharynx (assess risk for Ramsay hunt syndrome)

    • Nausea, vertigo, deafness (assess risk for Ramsay hunt syndrome in which CN 8 is often affected aswell as cerebellar pontine angle mass)

    • Multiple cranial nerve dysfunction: Diplopia, Bulbar weakness

    • Focal neurologic deficits

  • Sexual History: (To assess risk for HIV)

  • Prior Diagnostic Workup: