R. NICKBRYANMDPATRICIA A.HUDGINSMD
A 59-year-old woman presented for evaluation and treatment of multiple cranial nerve deficits. She had a several-year-long history of gradual hearing loss in her right ear. She did not have tinnitus, vertigo, or otalgia, but she had noticed some difficulty with her sense of balance. She also had dysphagia with occasional coughing and choking spells during swallowing that she was able to alleviate by turning her head to the right. However, she had lost 23 kg during the 6 months before presentation. Finally, 2 months before evaluation, she began to notice some right-sided facial muscle weakness. She denied having a hoarse or weak voice, visual changes, or any change in sensation or strength of her extremities.
Pahlavan S, Ryan M. Radiology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2006;132(3):343. doi:10.1001/archotol.132.3.343