Clinical Reasoning: A 41-Year-Old Man With Steroid-Responsive Hemiparesis

Neurology. 2026 Jan 27;106(2):e214088. doi: 10.1212/WNL.0000000000214088. Epub 2025 Dec 29.

Abstract

A 41-year-old, left-handed man was admitted to the hospital for workup of a 3-week history of headache, constant vertigo, diplopia, and left hemiparesis. An initial diagnosis was made, and the patient was treated with symptomatic improvement. He was discharged and then presented a few weeks later with recurrence of his symptoms which required additional diagnostic workup. This ultimately led to a diagnosis of a rare disorder. In this case report, we outline his clinical course and our reasoning at each step which led to our eventual definitive diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Clinical Reasoning*
  • Diagnosis, Differential
  • Diplopia / etiology
  • Humans
  • Male
  • Paresis* / diagnosis
  • Paresis* / drug therapy
  • Paresis* / etiology
  • Steroids* / therapeutic use

Substances

  • Steroids