A 44-year-old man presents to the clinic with a sudden onset of right-sided facial weakness that developed overnight. He states that he woke up this morning unable to close his right eye completely and noticed toothpaste dribbling from the right side of his mouth while brushing. He reports a metallic taste in his mouth and a sensation that sounds are “louder and booming” in his right ear. He denies any recent head trauma, tick bites, or rashes. He mentions recovering from a mild upper respiratory infection two weeks ago but is otherwise healthy. He has no history of diabetes or immunocompromise.

He is afebrile and appears anxious but comfortable. His blood pressure is 138/84 mmHg with a heart rate of 78 bpm and a respiratory rate of 14 breaths per minute.