Case presentation

 Ahmed hassan ahmed,18 years old male

,student live in kufa al abbasia,
 Patient presented with LT sided facial
asymetry since 6 days
 Condition started before 10 days with LT
sided earache(continous,aggrevated by
movement auricle)followed next day by
ear discharge(scanty,watery,odourless).
 After 3 days Small painfull blister appear
in LT auricle started red in colour then
ruptured and become black.
 Patient take treatment but condition
deteriorated and facial asymetry develop
in last 6 days involved upper and lower
parts of face Initially it was very slight
and the patient ignored it but gradually it
increased to its present condition.
 No hearing loss,no vertigo
 Review of system is negative
 Past medical:history of chicken pox during
childhood.
 Past surgical:negative
 Familay history is negative
 No history of drug allergy or chronic use
 Patient is smoker
 General examination:
 Patient Look well,comfortable,no pallor,no
cynosis,no juandice. His vital signs were
all within normal limits.
 Ear examination:
1)inspection:vesicular eruption involved the
concha(blak in color)
Normal EAC,,mastoid area
2)otoscope:normal EAC and TM
3)Fistula test negative
4)Hearing is normal
5)Free fieled speech test normal
7)Facial N. examination:LT sided complet
facial N palsy(disfiguring,inability to close
eye, slight movement corner mouth)grade
5