Discover and read the best of Twitter Threads about #lookatthetongue
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42yo with nasopharyngeal CA (in remission) s/p chemo/rad presents with 3 months of progressive posterior head/neck pain, and slurred speech. On PE, you notice the following. What are you seeing? What’s your ddx? (consent obtained). #PhysicalExam #IDConsults 1/
In this video, you see right sided atrophy, right sided deviation, and fasiculations R>L, indicating a peripheral 12th nerve palsy. He also had some slurred speech. Remainder of neuro exam WNL. Remember: atrophy and fasiculations = LMN process! 2/
This patient had difficulty with certain sounds and with slurring words. Dysarthria means a difficulty producing speech: cranial nerves VII, IX/X, & XII are vital to producing speech and these can be tested by asking the patient to say different sounds. 3/
