A half tingling throat

A woman in her 70s presented to the emergency department with a four day history of left sided sore throat, hoarseness, facial weakness, ear pain, tinnitus, and dysphagia.

Examination showed left facial palsy (facial droop and loss of forehead movement) and vesicles in the swollen left auricle and external auditory canal (fig 1). Eye closure and taste were unaffected, and the tongue did not deviate. Muscle strength of the limbs was normal, with no dysmetria or ataxia. The patient had no meningeal signs, headache, or nausea, and vital signs and temperature were normal. Laryngoscopy revealed left palatal palsy, injected aryepiglottic fold with shallow ulcers (fig 2 …