A 50-Year-Old Man with Left-Sided Weakness and Difficulty Speaking Clearly

NEJM Evid. 2025 Jan;4(1):EVIDmr2400331. doi: 10.1056/EVIDmr2400331. Epub 2024 Dec 24.

Abstract

Morning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 50-year-old man who presented for evaluation of weakness on the left side of his body and difficulty speaking clearly. Using questions, physical examination, and testing, an illness script for the presentation emerges; the differential is refined until a diagnosis is made.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Humans
  • Male
  • Middle Aged
  • Muscle Weakness* / diagnosis
  • Muscle Weakness* / etiology
  • Speech Disorders / diagnosis
  • Speech Disorders / etiology