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Solve the Medical Riddle: One Side of Her Face Suddenly Drooped and She Couldn’t Smile or Close Her Eye, Second Week

Editor’s note: Welcome to our ThirdAge feature that gives you a chance to play medical sleuth as we share the details of what happened when a patient presented with a problem that stumped the physician at first.

Last week, the patient reported her symptoms. The doctor proceeded with the examination using the components of the classic S-O-A-P notes, which are as follows:

S=Symptoms or Chief Complaint

O=Objective Findings

A=Assessment or Analysis

P=Treatment Plan or Recommendations

The doctor referred Marjorie to a neurologist. This week, we’ll learn what happened during Marjorie’s appointment with the neurologist.

By the time Marjorie got to her appointment with the neurologist, her facial paralysis had progressed somewhat. That’s why the neurologist decided to do an electromyography (EMG), which is a diagnostic procedure to ascertain the health of muscles as well as the motor neurons (nerve cells) that control them. The neurologist also did a CT scan just to be on the safe side, although he didn’t feel this was 100% necessary.

The neurologist repeated the PCP’s reassurance that Marjorie’s condition was probably not a stroke or a brain tumor, but he conferred with the PCP to go over Marjorie’s’ health history and the results of her physical exam. By then, the PCP and the neurologist felt they did indeed have their diagnosis . .

To be continued . . .

Come back to next Thursday to find out what some people have guessed the diagnosis might be.

Marie Savard, M.D., a former Medical Contributor for ABC News and a frequent keynote speaker around the world, is one of the most trusted voices on women’s health, wellness, and patient empowerment. She is the author of four books, including one that made the Wall Street Journal list of the best health books of 2009: “Ask Dr. Marie: What Women Need to Know about Hormones, Libido, and the Medical Problems No One Talks About.” Dr. Marie earned a B.S. in Nursing and an M.D. degree at the University of Pennsylvania. She has served as Director of the Center for Women’s Health at the Medical College of Pennsylvania, technical advisor to the United Nations’ Fourth World Conference on Women in Beijing, advisor to the American Board of Internal Medicine Subcommittee on Clinical Competency in Women’s Health, health columnist for Woman’s Day magazine, and senior medical consultant to Lifetime Television’s Strong Medicine. Please visit


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