Symmetric proximal weakness is most commonly associated with primary muscle disease (myopathy). However, diseases of the neuromuscular junction, neuropathies, spinal cord disease, and very rarely cerebral infarction can produce similar…
A. Dysarthria refers to abnormal phonic characteristics of speech production due to impairment of the motor processes of speech. This contrasts with aphasia, in which abnormalities of language underlie impaired…
Pulsatile tinnitus refers to a perception of sound that coincides with the heartbeat. It may arise from a vascular lesion causing disruption of laminar flow, leading to turbulence that produces…
Evaluation of hearing loss begins with determining whether one or both ears are involved. With bilateral symmetric hearing loss, symptoms are almost always slowly progressive over time. Unilateral hearing loss…
Patients use the term “dizziness” to refer to many qualitatively different symptoms. Lightheadedness, such as is seen with presyncope, gait imbalance, true vertigo, and, not uncommonly, generalized weakness or mental…
A. Acute continuous vertigo, with onset over seconds to hours, is a common symptom. It is often associated with nausea, vomiting, gait unsteadiness, head motion intolerance, and nystagmus. The main…
A. The upper motor neurons that innervate the face (corticobulbar tract) originate from the primary motor cortex in the frontal lobe and travel through corona radiata and genu of the…
Anisocoria refers to asymmetry in pupillary diameter between the two eyes. When pathologic, anisocoria indicates a disorder of pupillary constriction or dilation. If the disorder is of pupillary constriction, the…
