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Multiple Cranial Neuropathy (A Teaching Case) Video 1
On examination the patient’s blood pressure was 135/85 mmHg, the pulse 82 beats per minute, the respiratory rate 20 breaths per minute and the temperature 36.8 °C. The neurological examination revealed normal mental status and dysarthria.
Pupils were 3 mm in diameter and reactive to light. There was a bilateral ptosis, palsy of extraocular muscles (video 1) and a facial diplegia (video 2). An asymmetric palate and reduced gag reflex was also noted. On protrusion the tongue was slightly deviated to the right. The patient was unable to elevate his shoulders or extend his neck. Additionally, he had sensory ataxia and deep tendon reflexes were absent. Muscle strength was normal in all limbs (video 3).