Diagnostic Conundrum: A Weakness That Hasn’t Read the Textbook.

Case Records of the Severn Valley

  • Maciej Ostrowski Medical University of Lodz, Poland


A 56-year-old lady was admitted for an elective assessment of dysphagia and a droopy neck to a secondary referral outpatients Gastroenterology Unit. During a pre-procedure assessment, a nurse noticed a slight dyscoordination and unilateral preference. On further enquiry, the patient reported a distal weakness in her left upper and lower limb, and a mild facial droop with no speech disturbance. An initial diagnosis of a Cerebrovascular Accident (CVA) was made and the patient was transferred to a tertiary referral centre.