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JAMA Clinical Challenge
October 15, 2014

Facial Droop, Left-Sided Weakness, and Cystic Brain Lesions

Author Affiliations
  • 1Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Health System, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
  • 2Associate Editor, JAMA
JAMA. 2014;312(15):1581-1582. doi:10.1001/jama.2014.5553

A 73-year-old man with a history of hypertension and chronic kidney disease presents with a left facial droop and left leg weakness. The facial droop and leg weakness developed 3 weeks ago, while he was vacationing in upstate New York. His symptoms have not progressed since initial onset. He reports no rash, headache, joint pain, visual changes, fevers, night sweats, or weight loss. His cancer screening is up to date and unremarkable. He is a former smoker with a 12 pack-year history, having quit 40 years ago.

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