Conversation: The conversation between human and AI assistant.
[|Human|] I have a 23 yr old son who came to me (last Thurs) saying the right side of his face was numb and he felt like he had slightly swollen glands. His right pupil was smaller than the left and his right eye started to swell. When I finally got him to go to Ergent Care on Friday his neck was very painful and is was hurting in his muscles when he swallowed, his eyes were still the same. The doctor said he had strep throat. He gave him a zpak and sent him home. That next morning he started throwing up and he just kept getting worse. He went back to Ergent Care on Sunday morning because he couldn t stop throwing up and his ear was killing him. This is a young man that has had 3 back surgeries he can deal with pain. They gave him a different antibiotic and said he had an ear infection. They also gave him a shoot of antibiotic some medication for vomiing and pain medication. He started feeling better last night and early this morning, but tonight he is feeling awful again and he says his head is hurting now but his ear feels better. What should we do?
[|AI|]  Hello! Welcome on Chat Doctor ! I read carefully your question and would recommend bringing him to the ER for a brain CT scan, in order to exclude possible stroke. The fact that his right pupil is smaller than the left, and he has neck pain, could indicate an arterial dissection. From the other hand, an inner ear infection, may lead to a sinus thrombosis, which is associated to headache and vomiting. For this reason, the main thing to do is going to the ER for a brain CT scan or MRI. Hope you will find this answer helpful! Best wishes,