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A Protocol for Comprehensive Assessment of Bulbar Dysfunction in Amyotrophic Lateral Sclerosis (ALS)
Published on: February 21, 2011
A 36-Year-Old Woman with Left-Sided Weakness and Difficulty Speaking
Marina Martínez Sánchez1, Eugenia Garcia-Amor1, Laura Dorado Bouix1
1from the Training Programs in Neurology, Anatomic Pathology, Internal Medicine, and Cardiology at the Hospital Germans Trias i Pujol Barcelona and Universitat Autònoma de Barcelona, Spain.
NEJM Evidence
|July 28, 2026
Summary
This case report details a 36-year-old woman with sudden speech difficulty and left-sided weakness. The report guides readers through diagnosing complex neurological symptoms, including polyarthralgia and headaches.
Area of Science:
- Neurology
- Internal Medicine
- Medical Education
Background:
- Morning Report is a traditional medical education conference.
- It involves case presentations for collaborative diagnosis.
- This report simulates the Morning Report experience for readers.
Purpose of the Study:
- To present an interesting patient case for diagnostic learning.
- To guide readers through developing a differential diagnosis.
- To illustrate the process of refining a diagnosis based on clinical progression.
Main Methods:
- Case presentation of a 36-year-old woman.
- Description of presenting symptoms: sudden speech difficulty, left-sided weakness, polyarthralgia, weight loss, headaches.
- Utilizing questions, physical examination, and testing to develop an illness script.
Main Results:
- The case illustrates the iterative process of differential diagnosis.
- Clinical course progression aids in refining diagnostic possibilities.
- A final diagnosis is reached through systematic evaluation.
Conclusions:
- This case report effectively simulates the Morning Report learning environment.
- It highlights the importance of a thorough diagnostic approach for complex presentations.
- Readers can engage in differential diagnosis alongside the authors.
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