Triad of Sensory Findings Localises to Cortex- Analysis of 5 Cases

Abstract

BACKGROUNDA fifty-two-year-old man presented with acute onset right lower facial and ear numbness and facial weakness, after two weeks of the onset of symptoms. Examination revealed right central facial palsy, depressed corneal reflex and hemifacial sensory loss (mild over forehead, severe over lower cheek, jaw & pinna) Localization was proposed in brainstem Vs Cerebellopontine angle. MRI Brain revealed infarct in peri Rolandic area; four more patients had similar presentation over next few years.1 Core findings were ipsilateral graded facial sensory impairment with central facial palsy, ear involvement & impaired corneal reflex. Four had spastic hand.Hypothesis-Cortical lesions can have LMN-like presentation; impairment of facial and external ear (pinna) sensations, and attenuated corneal reflex.