Case 1: Question 2

A 60-year-old man collapsed while at work. After he regained consciousness in the emergency room, neurological exam was performed with the following abnormalities noted:

  • paralysis in the right arm and leg
  • dysarthria
  • deviation of the tongue to the left when protruded
  • loss of vibration, proprioception and discriminative touch sensation on the right side of the body (the face has normal sensation).

Question 2: Is the lesion above or below the foramen magnum?  Think about the reason for your answer.

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