Unheard

Nervous System & Special Senses


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"Loss of hearing is a common outpatient complaint with a wide differential diagnosis encompassing conductive, sensorineural, and mixed causes of deafness.\n\nHowever, this patient demonstrates several clinical signs which help shorten the diagnostic pathway: right sided facial weakness suggestive of a lower motor neuron (LMN) lesion of the facial nerve, and right sided numbness of the entire face, potentially indicating a lesion of the trigeminal nerve.\n\nIn addition, note that the Rinne test shows air conduction to be superior to bone conduction on both sides (i.e. there are no conduction defects), while the Weber test localizes to the left side. This indicates the presence of a right-sided sensorineural hearing loss; this is confirmed by audi"}]}

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