The patient is alert, oriented, and anxious. His speech is fluent and appropriate. His voice is mildly hoarse but there is no dysarthria. There is a left ptosis . The pupils are equal in size but the left reacts less briskly than the right, to both light and accomodation.
Visual field are full.
Extraocular motions are full, there is no diplopia or nystagmus. The fundi are clear and there is no papilledema. Facial sensation is intact. There is flattening of the left nasolabial fold with very mild weakness with effort. The palate elevates to the right .