A 52-year-old woman was admitted to a community hospital due to numbness and weakness in her left extremities and diagnosed with cerebral infarction in July 2015. Magnetic resonance imaging (MRI) revealed lesions in bilateral basal ganglion and corona radiata. The symptoms ameliorated after therapy for cerebral infarction. However, in October 2015, she developed a symptom of dizziness without obvious predisposing causes, which was followed by right-sided hemiplegia, slurred speech and spotted vision.

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Examination

She underwent brain magnetic resonance angiography (MRA) examination on admission to our hospital, which did not show abnormal blood vessels. Neurological examination showed weakness of the extremities and hypermyotonia of the left upper limb. Finger-to-nose and heel-to-shin testing revealed dysmetria. Rapid alternating movements were slowed and awkward bilaterally. Deep tendon reflex was graded 3 in the left upper extremity. Bilateral Babinski reflexes and Holmes rebound phenomena were positive.

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