Ear and audiology: forehead sparing facial palsy: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Ear and audiology: forehead sparing facial palsy

Sample item

A 62-year-old man with hypertension wakes with left lower facial droop, but he can wrinkle his forehead and close both eyes. Which statement is correct?

AThe lesion is in the parotid glandBA Bell palsy is certain because it is the commonest causeCThe lesion is within the Fallopian canalDAn upper motor neuron lesion is likely, so a central cause such as stroke must be sought

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. An upper motor neuron lesion is likely, so a central cause such as stroke must be sought

The upper face receives bilateral cortical innervation, so a supranuclear lesion spares the forehead. A lower motor neuron lesion paralyses the entire half of the face including the forehead. Forehead sparing in a vascular patient needs urgent neuroimaging.

Option by option

A. The lesion is in the parotid gland
A parotid lesion is infranuclear and would also paralyse the forehead.
B. A Bell palsy is certain because it is the commonest cause
Bell palsy is a lower motor neuron palsy and paralyses the forehead too.
C. The lesion is within the Fallopian canal
A lesion in the Fallopian canal is infranuclear and affects all branches.
D. An upper motor neuron lesion is likely, so a central cause such as stroke must be sought (correct)
Correct. Forehead sparing indicates a central lesion until proved otherwise.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, An upper motor neuron lesion is likely, so a central cause such as stroke must be sought. The upper face receives bilateral cortical innervation, so a supranuclear lesion spares the forehead.

Why is "The lesion is in the parotid gland" not the answer?

A parotid lesion is infranuclear and would also paralyse the forehead.

Why is "A Bell palsy is certain because it is the commonest cause" not the answer?

Bell palsy is a lower motor neuron palsy and paralyses the forehead too.

Why is "The lesion is within the Fallopian canal" not the answer?

A lesion in the Fallopian canal is infranuclear and affects all branches.

What concept does this question test?

It tests Ear and audiology: forehead sparing facial palsy in ENT. A lower motor neuron lesion paralyses the entire half of the face including the forehead. Forehead sparing in a vascular patient needs urgent neuroimaging.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Ear and audiology: forehead sparing facial palsy?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.