Violent Cough, Slurred Speech, and Ptosis in a Middle-Aged Man

Francesco Brigo, MD; Giampaolo Tomelleri, MD


August 23, 2022

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A 57-year-old man presents to the emergency department with left-sided facial, arm, and leg weakness along with slurred speech after suffering violent and repetitive bouts of coughing. His wife also suggests that his right eye is smaller than the left. The patient complains of pain over his right eye.

His medical history is notable for hypertension and smoking one pack of cigarettes per day for 10 years. He denies any illicit drug use. He does not consume alcohol. He is employed, does not exercise, and has a sedentary lifestyle. He has no history of previous head or neck injury.


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