CASE SCENARIO
A 65 years male presented with sudden onset of weakness of left upper and lower limb at 5 am in the morning. His wife noticed slurring of speech. She reported that he had coughing while drinking water.
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There was no loss of consciousness/convulsions/preceding fall/headache.
He was a hypertensive for 10 years on Tab. Amlodepine 5mg OD.
He was a chronic smoker since 30 years.
ON EXAMINATION:
Conscious, cooperative
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PULSE: 80/min, regular.
BP: 160/100mm Hg, Right arm,supine.
Xanthelesma+
CNS:
Conscious, co operative
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Higher mental functions: normal
Cranial nerve:
Angle of mouth deviated to right.
Loss of nasolabial fold on left side of face.
Motor:
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Hypotonia of left upper and lower limb.
Power grade 0 on left upper and lower limb.
Deep tendon reflexes exaggerated on left side.
Plantar extensor on left side.
Sensory: Reduced sensations on left half of the body.
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CVS:
S1,S2 normal.
Ejection systolic murmur in aortic area not conducted to carotids.
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This download link is referred from the post: MBBS All Subjects Clinical Case Scenarios (Clinical Case Studies)