22nd August 2024

A 30-year-old woman presents to A&E with a new neurological disturbance. She woke up to find that her left arm was weak

A 30-year-old woman presents to A&E with a new neurological disturbance. She woke up to find that her left arm was weak, she couldn’t use her left hand to do up her buttons, and she was struggling to get her words out. She reports slight nausea. She is usually fit and well apart from a history of seizures for which she has had numerous negative investigations and is not on any medication. On examination, you note that she is alert. She has left-sided weakness in her arm, there is drift without pronation and there is some give-way weakness. Her speech was stuttering which she says is an improvement from this morning when she could not speak at all. Her weakness improves gradually during the consultation. What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.