13th June 2023

A 45-year-old woman is admitted to the stroke ward with sudden onset of left-sided weakness

A 45-year-old woman is admitted to the stroke ward with sudden onset of left-sided weakness. On examination, she has 0/5 power in her left upper limb and left lower limb, as well as patchy reduced sensation to light touch in the left half of the body. Her cranial nerves are intact and there are no signs of higher cerebral dysfunction or cerebellar dysfunction. Hoover’s sign is positive. A CT brain is reported as normal and MRI with DWI does not show any acute ischaemia. Her past medical history includes asthma and anxiety with dysfunctional breathing.

Which of the following options is the most likely diagnosis?