Case study B A 72-year-old woman came to the emergency room…
Case study B A 72-year-old woman came to the emergency room with right facial weakness. She awoke in the morning with a “funny feeling” in her cheek and thought she might have accidentally bitten herself overnight. She looked in the mirror and noticed her right face was drooping a little. She also thought her speech sounded slightly slurred, so she called her wife to confirm this. Her wife recommended that she go to the emergency room and she complied. During examination, her right lower face showed significant delay and reduction of movements with smile, but she was able to raise both eyebrows. Taste on both sides of the anterior tongue was intact in response to mustard or jam on a swab. Hearing was normal and she had a normal gag reflex with symmetrical palatal elevation. Her speech sounded mildly slurred, but the patient reported that it had sounded worse in the morning. Tongue protrusion deviated notably to the right, and she had a weak cough. Strength testing in the limbs revealed no weakness. All limb and frontal release reflexes were normal.