There is flattening of the left nasolabial fold with very mild weakness with effort. The palate elevates to the right . The tongue deviates to the right . There is a brisk gag reflex bilaterally. There is no upper extremity drift.
Strength is full in all extremities.
There is subjective decrease in pinprick and temperature sensation over the lateral aspect of the right forearm and hand , involving the thumb and index and middle fingers. Proprioception is intact throughout. Stereognosis is intact and there is no extinction on bilateral simultaneous stimulation. Deep tendon reflexes are normal and symmetric. There is no Babinski or Hoffman's reflex.