A 65 y/o man develops (a) subtle slurring of speech, combined with a (b) loss of pain and thermal sensation on the right side of the face and left side of the body. A careful examination reveals that he has (c) paralysis of facial muscles on the right side involving upper and lower portions of the face. Masticatory muscles appear to function normally, and there is no deviation on the protrusion.
Explain the signs and symptoms that are indicated by a, b, and c.
Where is the lesion? Identify the blood vessel involved.
A 65 y/o man develops
(a) subtle slurring of speech,
This might be due to damage of the nucleus ambiguus, which gives rise to the motor fibers of CN X (vagus nerve). Damage here would affect speech.
combined with a (b) loss of pain and thermal sensation on the right side of the face and left side of the body.
The loss of pain/temperature on ...
The solution explains the causes of all of the symptoms mentioned in the problem and identifies the location of the lesion and the artery involved.