Bell's palsy

My last post was about a patient with MS plaques, but that same patient also had a meningioma against the mastoid air cells on the left side. I really didn't want to write about the same patient, so I did some research and I was very interested in Bell's Palsy.

I work as an x-ray tech/MA at an Urgent Care. A few days ago, we had a patient come in with symptoms of left sided numbness and weakness and a headache behind the left ear. When the patient would squint, her left side would not squint as well as the right and when she tried to open her mouth, her left side would not open as much.

After the doctor had told me her diagnosis, I began to ask lots of questions. My patients' diagnosis was, of course, Bell's palsy. Bell's palsy is a paralysis of the seventh cranial nerve (facial nerve). It could be the consequence of a tumor, stroke, infection, swelling, etc. When I got home I did more research and found that the most common cause of Bell's palsy is the herpes simplex virus (HSV).

Most of the time the symptoms will go away on its own, but for some unlucky patients surgery may be their only option. My patient, however, was prescribed prednisone to help with the swelling of the nerve. Hopefully her symptoms will start to dissipate, but only time will tell.


References:

http://mayoclinic.com/

http://yassermetwally.files.wordpress.com/2009/01/bell.jpg

multiple sclerosis

A patient came in the other day with a known history of Multiple Sclerosis and right leg numbness X 2 years. His PCP ordered an MRI brain with and without contrast. I noticed when scanning without contrast there were tiny areas that were dark in T1 (low signal) and bright in T2 and Flair (high signal). After injecting contrast the areas I noticed got brighter or enhanced in T1. With the patients known history of the disease, the Radiologist read this exam as active MS. (Active MS because when injecting contrast, the new lesions were highlighted. If the lesions were old, they would not be highlight).

Multiple sclerosis is a central nervous system disease that breaks down the myelin sheath. It unfortunately is found mostly in young adults; especially women. MS doesn't only occur in the brain, it also occurs in the spinal cord and depending on where it is located and how big the lesion is determines the patients symptoms.

MS effects everyone differently. Common symptoms include: loss of vision, numbness of extremities or parts of the body (like my patient), urination problems, slowed thinking, and etc. Because each person is effected differently by MS, it can be extremely hard to diagnose. Therefore, the best way to diagnose MS is through the use of MRI with and without contrast.

References:

http://www.wendys-ms-site.com/whatis.html

Intro

My name is Lacey. I'm an x-ray tech in Indianapolis and I'm very excited to start MRI rotations this semester. I will keep you posted with all the cool things I get to see in MRI's and CT's!!