American Board of Psychiatry and Neurology (ABPN) Practice Exam 2025 – Comprehensive All-in-One Guide to Exam Success!

Acute facial paresis following ear pain is most typically associated with Bell's palsy. This condition is characterized by a sudden onset of unilateral facial weakness or paralysis that often occurs in the context of an infection or inflammation. The proximity of the ear can indicate involvement of the facial nerve, which runs close to the structures of the ear and can be affected by viral infections, particularly in the context of otitis media or herpes virus infections.

Bell's palsy is believed to result from inflammatory changes affecting the facial nerve as it traverses through the temporal bone, often leading to accompanied pain or discomfort around the ear area. The acute presentation and the specific location of the symptoms help to distinguish Bell's palsy from other conditions.

In contrast, trigeminal neuralgia is characterized by severe facial pain along the distribution of the trigeminal nerve, rather than facial weakness. Facial dystonia involves involuntary muscle contractions and abnormal postures, and does not present with acute paresis. An acute lateral medullary infarct may cause symptoms such as dizziness, difficulty swallowing, and other neurological signs, but would not typically present primarily with ear pain and sudden facial weakness. Thus, the association of acute facial paresis following ear pain strongly points to Bell's pals