Answer: B, C, D, E.
Examination & Imaging Findings: There is atrophy of the right temporalis (1) and masseter (2) muscles which could be appreciated on the physical examination. There is fluid in the right tympanic bulla (3). The tympanic membrane appeared normal on otoscopic examination. The intracranial mass is not labeled...were you able to identify it? Continue on for more discussion.
Additional History: Cranial nerve examination results:
- menace response: absent OD (+0), likely due to descemetocele / normal OS (+2)
- palpebral reflex: OU (+2)
- corneal sensation: present bilaterally but subjectively slightly decreased OD in comparison to OS
Question: Which one of the following nerves best accounts for the patient's clinical signs?
Question: Is the following abnormality an important differential?
Nerve sheath tumor
Olfactory lobe meningioma
Toxo or cocci granuloma