A 36-Year-Old Woman with Left-Sided Weakness and Difficulty Speaking.

Martínez Sánchez, Marina; Garcia-Amor, Eugenia; Dorado Bouix, Laura; Fernandez Romero, Juan Pablo; Torruella Trias, Berta; Junca Puig, Gladys; Kasa, Gizem; Millan Torne, Mònica · NEJM Evid · 2026

case_report · Level V

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Abstract

AbstractMorning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 36-year-old woman who presented with sudden onset of difficulty speaking and left-sided weakness. Additional symptoms included generalized polyarthralgia, weight loss, and severe headaches during the preceding 4 months. Using questions, physical examination, and testing, an illness script for the presentation emerges. As the clinical course progresses, the differential is refined until a diagnosis is made.

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