Onset: typically rapid (over 24–48 hours).
Typically unilateral (very rarely bilateral) lower motor neuron-type facial wea...
Artificial tears should be used frequently to lubricate the cornea.
The ipsilateral eye should be patched or taped shut at night to avoid drying and infection.
Recove...
Start steroid treatment immediately
Patients who do not recover complete facial nerve function should be referred to ENT and/or ophthalmology for...
Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell’s palsy. Otolaryngol Head Neck Surg. 2013;149(Suppl 3 ):S1–S27. ...
G51.0 Bell's palsy
193093009 Bell's palsy
12239621000119103 Bells palsy of left side of face
12239661000119108 Bells palsy of right side of face
46061007 Bell's phenomenon
Look closely at the voluntary movement on the upper part of the face on the affected side; in Bell palsy, all of the muscles are involved (weak or paralyzed), whereas in a stroke, the ...
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Septal amyloidosis shows characteristic apple green birefringence of amyloid on Congo red stain.
FIGURE 28.2. Radiographs illustrating the different stages of sarcoidosis. A: Stage I. Bilateral hilar adenopathy and paratracheal adenopathy with normal lung fields. B: Stage II. Bilateral hilar adenopathy with interstitial lung field involvement. C: Stage III. Lung field involvement only. D: Stage IV. Severely fibrotic lungs with volume loss and cyst formation.
FIGURE 28.2. Radiographs illustrating the different stages of sarcoidosis. A: Stage I. Bilateral hilar adenopathy and paratracheal adenopa...
<bold>FIG. 93.1.</bold> A: Electron micrograph of amyloid surrounding a cardiac myocyte (×20, 125). B: High-magnification image showing typical fi illar nature of amyloid deposit (×68,125).
<bold>FIG. 93.1.</bold> A: Electron micrograph of amyloid surrounding a cardiac myocyte (×20, 125). B: High-magnification imag...
<bold>FIG. 93.16.</bold> Two-dimensional echocardiogram for the same subject as depicted in Fig. 93.6. Classic features of amyloid cardiomyopathy are thickened intraventricular septum <italic>(IVS)</bold>, left ventricular posterior wall <italic>(PW)</bold>, and enlarged left atrium <italic>(LA)</bold>.
<bold>FIG. 93.16.</bold> Two-dimensional echocardiogram for the same subject as depicted in Fig. 93.6. Classic features of amy...
<bold>FIG. 93.17.</bold> Electrocardiogram of a patient with amyloid cardiomyopathy. Low voltage is a prominent feature, and the standard, but erroneous, interpretation as "septal infarct, age indeterminate" is common.
<bold>FIG. 93.17.</bold> Electrocardiogram of a patient with amyloid cardiomyopathy. Low voltage is a prominent feature, and t...
Figure 5.62. Sarcoidosis-related retinal phlebitis with perivascular exudates known as "candle-wax drippings."
<bold>Figure 31.19</bold> Hemodynamics of amyloidosis, a restrictive cardiomyopathy. The elevated right atrial pressure, Kussmaul sign, and prominent Y descents <bold>(A)</bold> as well as the dip and plateau in the right ventricular tracing <bold>(B)</bold> are indicative of severe right ventricular dysfunction and not constriction. Prominent V waves <bold>(C)</bold> are present in the wedge tracing despite the lack of mitral regurgitation and reflect the volume overload in the stiff atrium, characteristic of amy...
<bold>Figure 31.19</bold> Hemodynamics of amyloidosis, a restrictive cardiomyopathy. The elevated right atrial pressure, Kussm...
<bold>Figure 31.20</bold> Electrocardiogram of a patient with amyloid. Classic findings include low limb lead voltage but preserved precordial voltage, nonspecific ST changes, P wave prominence, and pseudoinfarct pattern with precordial Q waves.
<bold>Figure 31.20</bold> Electrocardiogram of a patient with amyloid. Classic findings include low limb lead voltage but pres...
<bold>Figure 31.22</bold> Endomyocardial biopsy of patient with amyloid. A. Even without congo red staining, amyloid is suggested by separation of myofibrils and infiltration of blood vessels by pink amorphous proteinaceous material. Hypertrophy notably absent as well. <bold>B.</bold> At autopsy, left atrial walls appear leathery and waxy, consistent with endocardial deposition of amyloid protein.
<bold>Figure 31.22</bold> Endomyocardial biopsy of patient with amyloid. A. Even without congo red staining, amyloid is sugges...
Homeless diabetic man with painful foot showing gangrene and dystrophic nails
Parasternal long (A) and apical four-chamber (B) and mitral inflow (C) in advanced cardiac amyloidosis. Note that the left ventricular size is normal with markedly thickened ventricular walls and has its characteristic granular sparkling appearance. DT, deceleration time; LA, left atrium; LV, left ventricle; PE, pericardial effusion; PL EFF, pleural effusion; pm, papillary muscle; RA, right atrium; RV, right ventricle.
Parasternal long (A) and apical four-chamber (B) and mitral inflow (C) in advanced cardiac amyloidosis. Note that the left ventricular siz...
Schaumann body consists of fragmented irregular calcified basophilic refractile structure in the cytoplasm of a multinucleated giant cell in a sarcoidosis granuloma.
Schaumann body consists of fragmented irregular calcified basophilic refractile structure in the cytoplasm of a multinucleated giant cell ...
<bold><italic>Figure 14.60.</bold></bold> Pretibial diabetic skin changes: necrobiosis lipoidica diabeticorum.
Bell palsy: peripheral (lower motor neuro) paralysis of the facial nerve
FIG. 11 Diabetic patient with acute spontaneous onset of low back pain and fever. <bold>A,B:</bold> Dramatic elements of two-level spondylodiscitis, L3-5, with secondary communicating psoas abscess component.
FIG. 11 Diabetic patient with acute spontaneous onset of low back pain and fever. <bold>A,B:</bold> Dramatic elements of two-l...
<bold>Figure 11.93. Neuropathic (Charcot) joints in two diabetic patients. A.</bold> Radiographs of both feet show bilateral neuropathic joints at the first metatarsophalangeal joints (<italic>arrows</bold>). On the left there is periarticular osteopenia, indicating superimposed infection. Frontal <bold>(B)</bold> and lateral <bold>(C)</bold> knee radiographs of another patient show disintegration of the knee joint with considerable bony debris (" bag of bones") and a large joint effusion. In the past, involvement o...
<bold>Figure 11.93. Neuropathic (Charcot) joints in two diabetic patients. A.</bold> Radiographs of both feet show bilateral n...
Necrobiosis lipoidica diabeticorum. Atrophic patch present x 6 mo.
<bold>FIGURE 11-44. Cardiac amyloidosis.</bold><bold>A.</bold> A section of myocardium stained with Congo red shows interstitial, pink-staining deposits of amyloid. <bold>B.</bold> Under polarized light, the same section displays the characteristic green birefringence of amyloid fibrils.
<bold>FIGURE 11-44. Cardiac amyloidosis.</bold><bold>A.</bold> A section of myocardium stained with Congo red show...
Bell's palsy. The patient had Lyme disease diagnosed 2 weeks before. Right-sided facial weakness.
Neurologic dysfunction in Bell palsy
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Diagnosing Bell Palsy. Ask the patient to close his eyes.
Diagnosing Bell Palsy. Ask the patient to raise his eyebrows.
Tiny ixodid nymphal tick