Four-year-old presents with right arm weakness when crying
History & Exam
- A four-year-old girl with no previous medical history presents with two years of spells of right arm “clumsiness” and right facial droop after crying, which typically resolve in 5-10 minutes. After a recent fever and diarrhea from norovirus (in a preschool outbreak), the spells became more frequent and longer lasting, prompting imaging.
- Review of further history was unremarkable other than noted Korean ancestry and mother reporting severe migraines and similar spells of left hand weakness at times of stress. The mother also had a sibling who died in childhood from a stroke. The patient has an older sibling, who is healthy.
- Exam was normal.
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