A patient with a positive Lyme titer presents with left-sided unilateral facial droop and inability to close the left eye. This is most likely due to:
A. Trigeminal neuralgia
B. Temporomandibular joint syndrome
C. Multiple sclerosis
D. Bell's palsy
ANS: D
Bell's palsy is a unilateral paralysis of the face. The etiology is uncertain, but the paralysis is thought to be due to an inflammation of cranial nerve (CN) VII. Lyme disease is a common cause. The onset of Bell's palsy is sudden, and the symptoms are unilateral. The affected side of the face droops with asymmetrical facial movement; there is pain in or around the ear, excessive lacrimation and salivation, and inability to close the eye.
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