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May 21, 1955


JAMA. 1955;158(3):183-184. doi:10.1001/jama.1955.02960030033010

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A 51-year-old white woman was hospitalized because of headache, weight loss, and weakness of the right arm and leg. Her right pupil was noted to be enlarged 22 years before admission, and gradually both pupils became of equal size. Eight years before admission, her right leg and thigh, right arm and shoulder, and the right side of her face were noted to perspire excessively. In recent years, when not perspiring, these regions felt cold. For four years she had had severe throbbing occipital headaches, which recently had spread to the frontal regions. These headaches often awakened her from sleep; they were associated with stiffness of the neck and made worse by bending the head. For two years she had noted her tongue deviated to the left when protruded, and she believed her face had become asymmetrical. Her right lower extremity became almost completely paralyzed suddenly on awakening about two years

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