• Red Flag:
  • Heairng loss, vertigo
  • Chronic course (> 3 wks) → consider cancer, such as head-and-neck cancer
  • Vesicles → Ramsay Hunt Syndrome
  • Bilateral → !GBS - Guillain-Barré syndrome, Lyme Disease, Neoplasm
• R/o ear disease
  • Chronic otitis media (SOM, AOM)
  • !Acute mastoiditis
  • Cholesteatoma
• MRI to r/o retrocholear pathology

Lesion & Effect

• CN VII Facial

1. Just efferent to internal acoustic meatus
2. Facial canal (after synapsing with geniculate ganglion)
   • Give off chroda tympani
   • Give off stapedius
3. Just efferent to stylomastoid foramen

Risk Factor

• 3rd trimester Pregnancy, Post-partum Complications
• Diabetes Mellitus

Treatment

• 60-80% self-limited, low recurrence
• Medications
  • Prednisone within 72 hours
  • Acyclovir within 72 hours to cover forRamsay Hunt Syndrome
  • Eye care
    • Artificial tear or ointment
    • Eye patch at night (avoid corneal abrasion)