Still More Weakness

Nervous System & Special Senses

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This elderly lady has developed hemiparesis of acute onset - an extremely common presentation in emergency medicine.\n\nIn the overwhelming majority of cases, this is due to a stroke; that said, it is important to keep in mind that stroke is not the only cause of this presentation; a thorough history and examination should always be obtained in these patients.\n\nHer history in turn reveals an interesting and anomalous finding: the presence of concomitant neck pain.\n\nNeck pain in a patient with hemiplegia should prompt consideration of three key possibilities: vertebral arterial dissection, cervical tumor (possibly with acute hemorrhage), and cervical spinal epidural hematoma (SEH) formation.\n\nThe neck pain might also be an incidental finding; "}]}

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