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Clinical Reasoning: Rare Cause of Hemiparesis and Ataxia in a 36-Year-Old Man
Neurology ( IF 7.7 ) Pub Date : 2022-02-08 , DOI: 10.1212/wnl.0000000000013142
Jessica Decker 1 , Mini Singh 1
Affiliation  

A 36-year-old left-hand dominant Haitian man presented with a 1-week history of intractable headache, slurred speech, and right facial and hemibody weakness and numbness. In retrospect, he reported episodes of blurred vision, painful oral ulcers, and a nonpruritic rash for 3 years. He was found to have a right retinal hemorrhage on a recent eye examination that was treated with ocular VEGF injections without improvement. On examination, he had oral aphthous ulcers and white papulopustular lesions on the trunk and extremities. His neurologic examination was significant for right-sided facial weakness in an upper motor neuron type pattern, dysarthria, right-sided hemiparesis and hemianesthesia, and right upper extremity ataxia.



中文翻译:

临床推理:一名 36 岁男性偏瘫和共济失调的罕见原因

一名 36 岁的海地左撇子男性,因顽固性头痛、言语不清、右侧面部和半身无力和麻木 1 周就诊。回想起来,他报告视力模糊、口腔溃疡疼痛和非瘙痒性皮疹发作 3 年。在最近的一次眼科检查中发现他有右视网膜出血,该检查用眼部 VEGF 注射治疗,但没有改善。经检查,他的躯干和四肢有口腔阿弗他溃疡和白色丘疹脓疱病灶。他的神经系统检查对上运动神经元型模式的右侧面部无力、构音障碍、右侧偏瘫和偏瘫以及右上肢共济失调具有重要意义。

更新日期:2022-02-09
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