Case Presentation: A 46-year-old female with a past medical history of hypertension, diabetes mellitus, and asthma who initially presented 2 weeks prior to the emergency department for right-sided facial paralysis and was diagnosed with idiopathic facial paralysis (Bell’s palsy). Despite being started on prednisone and valaciclovir, 2 weeks later she had suddenly developed left-sided facial [...]

Case Presentation: A 61-year-old female with a history of non-alcoholic steatohepatitis (NASH) cirrhosis complicated by hepatocellular carcinoma (HCC), who underwent a liver transplant 2 months prior, presented to an outpatient clinic complaining of several days of fatigue, headache, nausea, vomiting, abdominal pain and confusion. Her headaches were new since the transplant. She denied any fevers, [...]

Case Presentation: A 70-year-old gentleman with past medical history significant for chronic hypoxic and hypercapneic respiratory failure from chronic obstructive pulmonary disease (FEV1 of 0.76 liters, 22% of predicted), hyperlipidemia, and hypertension presented with worsening exertional shortness of breath of four days duration. He also had dry cough. He denied fever, chills, chest pain, paroxysmal nocturnal dyspnea or [...]

Case Presentation: A 28 year old woman with a history of metastatic adenocarcinoma and peritoneal carcinomatosis with partial bowel obstruction presented with 6 days of progressive nausea and vomiting. The patient also reported chest pain that was associated with retching and mild shortness of breath. She experienced change in vocal quality over the past few [...]

Case Presentation: A 65-year-old female with a history of sphenoid sinusitis status post recent fiberoptic endoscopic sinus surgery presented with one week of neck stiffness and two days of fever, headache, photosensitivity, and diplopia. Vital signs were: temperature 102.6, heart rate 82, respiratory rate 20, blood pressure 122/45 and 95% room air O2 saturation. Physical [...]

Case Presentation: A 36-year-old G9P9 Jehovah’s Witness female with no significant past medical history, presented to the emergency department with a 2-week history of postural headaches and double vision. Neurological examination was normal except for left abducens nerve palsy. CTA of the head was unremarkable, but an MRI of the head revealed diffuse smooth dural [...]

Case Presentation: A 6-year-old male with 4-month history of recurrent otitis media presented with one day of headache, ear pain, and left-sided facial droop. Parents claimed that he completed multiple courses of different antibiotics and steroids with incomplete resolution of symptoms. On presentation, he was afebrile. Physical exam was notable for left facial paresis House-Brackmann [...]

Case Presentation: 71-year-old African American female with history of chronic right ear infection/mastoiditis, hypertension, hyperlipidemia, stroke with residual expressive aphasia, diabetes mellitus type II and atrial fibrillation, presented to the ED for diplopia and pain to the right face. Initially the diagnosis of giant-cell arteritis was entertained and temporal artery biopsy showed no evidence of [...]

Case Presentation: Syphilis is known as the “Great Imitator” for good reason. With its insidious onset and nonspecific presentation, it is often mistaken for other diagnoses or overlooked altogether. Here, we describe a case of an isolated facial nerve palsy as a rare manifestation of neurosyphilis. A 53-year-old man presented to urgent care with acute-onset [...]

Case Presentation: A 47-year-old male with a past medical history of Bell’s palsy, hypertension, end-stage renal disease on hemodialysis, papillary thyroid cancer s/p thyroidectomy, and post-surgical hypothyroidism presented with new-onset left sided ptosis, mydriasis and retro-orbital pain. Approximately, three weeks ago he experienced similar symptoms without corresponding headache that self-resolved. The review of systems was [...]