Acute Onset Hemiplegia - Page #1

Author: Morteza Khodaee, MD, MPH
Co Author #1: Justin A. Lee, MD

61 year old male presents to clinic with a 3-day history of weakness in his right upper and lower extremities. He is unable to move his entire right side. He denies headache, shortness of breath, fever, and chest pain. He was discharged from hospital 5 days ago after a 2 ½ week of hospitalization for a liver abscess and diverticulitis. He is on IV Ceftriaxone and oral Metronidazole for his liver abscess. Past medical history is significant for tuberculosis status post right lobectomy at age 22 and hyperlipidemia. He has a 20-pack-year history of smoking but quit in his 20's. He is a social drinker and denies using any illicit drugs.

Physical Exam:
BP is 162/94, otherwise vital signs are unremarkable. He is alert, oriented, and in no acute distress. Neurological exam reveals normal CN II-XII, normal speech, and normal sensory exam with no facial droop. He has generalized right upper and lower extremity weakness. Reflexes are normal bilaterally.

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