Is It a Stroke, or a Stout Neck?

The patient has a fairly normal cardiac exam. His neuro exam, i would be interested in again, this is something that can also be somewhat confounded by the nolicitating medcities on things like that. Is it an upper motor neuron lesion, or a lower motor neron lesion? And if he does have true weakness, you know, i'm already thinking in the framework for weakness now. But we don't know yet if there's true weakness present on exam.