Internal Medicine

0521779407-B01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:52

224 Bartter’s Syndrome Bell’s Palsy

■Distinguish from other causes of salt wasting, including diuretic

abuse, cystic fibrosis and Gitelman’s syndrome

management

n/a

specific therapy

■KCl supplements, indomethacin – may need Mg supplements

➣NaCl supplements (in neonates)

➣May need growth hormone

follow-up

To ensure growth and response to therapy

complications and prognosis

Short stature, failure to thrive, constipation and volume depletion

Nephrocalcinosis and renal insufficiency

Bell’s Palsy.........................................

CHAD CHRISTINE, MD

history & physical

■Acute or subacute onset of unilateral facial weakness

■May progress over several hours or even a day

■Often preceded or accompanied by periaural pain

■Impairment of taste, lacrimation or hyperacusis common

■Weakness interferes w/ eyelid closure

■Difficulty eating & drinking

■Variable lower motor neuron weakness

■Other cranial nerves spared

■Examine ear & acoustic foramen to evaluate for herpes zoster infec-

tion (Ramsay Hunt syndrome)

tests

■Diagnosis made clinically

■Brain imaging performed if atypical presentation

differential diagnosis

■Tumors, trauma, stroke, bacterial infection, Ramsay Hunt syndrome,

sarcoidosis excluded clinically

■Lyme disease & AIDS differentiated serologically