Certified Neuroscience Registered Nurse (CNRN) Practice Exam

Which condition should be ruled out in a young patient presenting with Bell's palsy?

1. Hypertension

2. Diabetes

3. Stroke

4. Multiple Sclerosis

The correct answer is: Diabetes

In evaluating a young patient presenting with Bell's palsy, it is crucial to rule out a stroke. Bell's palsy typically presents as sudden onset facial weakness or paralysis, often on one side of the face. While diabetes is a risk factor for various neurological conditions, it is not primarily associated with Bell's palsy in younger individuals. Stroke, on the other hand, can present similarly with unilateral facial weakness; however, it may also involve other neurological deficits such as limb weakness, altered speech, or changes in consciousness. Determining whether the cause of facial paralysis is Bell's palsy or a stroke is crucial because the management and implications are significantly different. In cases where a young patient shows symptoms of unilateral facial paralysis, conducting a thorough assessment, including potentially imaging studies, is important to ensure that a stroke is not the underlying cause, especially if there are risk factors present (e.g., a history of migraines, contraceptive use, or thrombophilia). Early identification of a stroke can lead to timely intervention, which is critical for improving outcomes.