Clinical Case · trainee

Sudden facial weakness

History

A 40-year-old develops acute left facial weakness over a day, with the left brow and lower face involved. Hearing is subjectively normal. Audiometry is normal bilaterally; tympanometry is type A bilaterally.

Findings

Pure-tone audiogram

0204060801002505001k2k4k8kFrequency (Hz)Hearing level (dB HL)
○ Right ear✕ Left ear

Acoustic reflex grid

Stim. Right
Stim. Left
Probe Right
Present
Present
Probe Left
Absent
Absent

Reflexes are absent with the probe in the left ear only. What does this localise?