A 55 year old right-handed man with a previous medical history of hepatitis C, hypertension, 40 pack years of smoking, and asthma presented to our hospital Emergency Department with the complaint of mild numbness involving two digits of his left hand, the left corner of his mouth, and the left side of his tongue. The onset was sudden and without prodrome approximately 6 hours prior to ED arrival. Symptoms were persistent from onset through presentation. Blood pressure on admission was 104/69 mmHg and EKG demonstrated normal sinus rhythm. The patient denied recent illness, trauma, headache, confusion, mental impairment, or previous episodes of similar symptomatology.
Examination:
General physical and neurological examination were normal except subtle hypoesthesia to temperature, light touch, and pinprick in the distal palmar aspect of the first 2 digits of the left hand, around the left corner of the mouth including the upper and lower lips, and on the left side of the tongue. No other cranial nerve deficits or sensory deficits were found.
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