Exam for Peripheral 7th Nerve Dysfunction

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.

Exam:

  • Neurologic Exam (Full exam always required for evaluation of a neurologic symptoms or condition). Specific exam maneuvers relevant to the evaluation of this presenting symptom includes:

    • Mental status: Any abnormality may suggest a meningitic process

    • Cranial Nerves: Any dysfunction other than CN 7 broadens the differential to conditions that can cause multiple cranial neuropathies which would involve advanced imaging and analysis of CSF and additional serum studies.

    • Focal Deficit: Suggests a structural abnormality requiring advanced imaging

  • Additional Exam

    • Examination of the external ear, ear canal, and ear drum looking for vesicles (assess for varicella zoster virus)

    • Examination of the oropharynx (assess for varicella zoster virus)

    • Palpation of the parotid glands and visual examination of face for swelling (assess for parotid gland tumor)

    • General skin exam to assess for skin changes suggestive of Lyme