Pharmacology · patient case question
What medication is indicated for this patient?
Patient case: Facial droop with preserved eye closure
Scenario: A patient whose face DROOPS but who CAN still close the eye.
Show answer and explanation
Correct answer: C. Antiviral
- A. Antibacterials have no role in a viral cranial neuropathy.
- B. Antihistamines treat type I hypersensitivity reactions.
- C. Correct. Acute peripheral facial palsy — whether Bell's palsy (HSV-1 reactivation) or Ramsay Hunt syndrome (VZV reactivation) — is treated with an ANTIVIRAL (aciclovir, valaciclovir or famciclovir) COMBINED WITH CORTICOSTEROIDS, started as early as possible, ideally within 72 hours of onset.
- D. Antifungals treat candidiasis and other fungal disease; there is no fungal aetiology here.
Note: Corticosteroids are the treatment with the strongest evidence in Bell's palsy; antivirals are added, and their benefit is clearest in Ramsay Hunt syndrome.