Facial numbness differential

Bell's palsy is a type of facial paralysis that results in an inability to control the facial muscles on the affected side. The cause of Bell's palsy is unknown. The condition normally gets better by itself with most achieving normal or near-normal function. Bell's palsy is characterized by a one-sided facial droop that comes on within 72 hours.
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Chapter 13 - Evaluation of the patient with "numbness"

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Discussions : MS Connection

The patient year-old female had a history of breast cancer. Despite conservative restoration and no caries, the dentist completed endodontic treatment. Following treatment, there was no change in symptoms; the case represents metastasis to the jaw. Figure 2: Radiographs acquired due to report of jaw pain and numbness in the lip. The patient year-old male had a history of treated prostate cancer. Radiolucent lesion present extending to the inferior border of the mandible with risk of pathologic fracture.
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Bell's Palsy: Diagnosis and Management

However, numbness is actually loss of sensation, either partial hypesthesia or complete anesthesia. Numbness is often accompanied by abnormal sensations of tingling pins-and-needles unrelated to a sensory stimulus paresthesias. Other manifestations eg, pain, extremity weakness, nonsensory cranial nerve dysfunction may also be present depending on the cause. In addition, infections, diabetic foot ulcers, and injuries may not be recognized, leading to delayed treatment.
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Given that the treatments and outcomes for MS and its mimics are so different, neurologists should take care to establish a diagnosis early, said Sid Pawate, MD, Assistant Professor of Neurology at Vanderbilt University School of Medicine in Nashville. Because of the varied clinical presentation of MS, a wide variety of conditions enter the differential diagnosis. Because of the central role that MRI plays in MS diagnosis, imaging mimics that cause white matter lesions also need to be considered, said Dr. Typically, the white matter lesions seen in MS are periventricular, juxtacortical, and callososeptal in location.
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