Facial nerve palsy on the patient's right

This is a picture of the patient as she tries to show her teeth. There is loss of prominence of the right nasolabial fold. She got this problem come onovernight and she was in her doctor's office the same day. Lyme's disease, Sarcoidosis, Multiple sclerosis & stroke should come to mind immediately. Lymes disease is tested for by checking  Lyme antibody titer (serology) but confirmation comes from western blot for lyme. Sarcoidosis screening is done by checking for hilar lymphadenopathy by a Chest XRay. They also are anergic and will have no reaction to PPD and Anergy panel (skin tests).