Intended for healthcare professionals

Endgames Case Review

A man with weak limbs

BMJ 2019; 367 doi: (Published 07 November 2019) Cite this as: BMJ 2019;367:l6233
  1. Shing Fung Lee, resident specialist,
  2. Pui Lam Yip, resident,
  3. Frank Chi Sing Wong, chief of service
  1. Department of Clinical Oncology, Tuen Mun Hospital, New Territory West Cluster Hospital Authority, Hong Kong
  1. Correspondence to SF Lee leesfm{at}

A 58 year old man presented with one week of progressive right sided weakness and headache. He drank approximately 7 units of alcohol a week and had stopped smoking cigarettes 20 years ago (10 pack year history). He had no recent head injuries and took no medications or recreational drugs. He had no fever, weight loss, or night sweats and was fully alert. He had no signs of meningism or papilloedema and was afebrile with normal observations. Power in his right upper and lower limbs was of Medical Research Council grade 4/51 and he had …

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