ABSTRACT
A 32-year-old woman attends the neurology outpatient department for her first follow-up appointment. Her history is somewhat detailed and features several separate episodes.
The initial presentation was five months previously with pins and needles in her left foot. This subsided after a few days and at the time the patient attributed it to having slept in an awkward position. However, six weeks later she noticed clumsiness in her right hand which was not of a severe degree, but was sufficient to interfere with her ability to play the piano and prompted her to consult her GP. By the time of the appointment, the clumsiness had resolved. However, the doctor did find a right upgoing plantar reflex on examination.
