Case 21-1972

Presentation of CaseA 60-year-old man was admitted to the hospital because of dysphasia.He had been well until two years previously, when intermittent claudication developed, followed by impotence. Eight months before admission there was the sudden onset of tinnitus, deafness and vertigo, which cleared after three days. A tentative diagnosis of polycythemia was made, and occasional venesections were performed. Nine days before entry there were two brief episodes of weakness of the right hand. Two days later he began to experience difficulty in expressing himself verbally. He was taken to another hospital, where he was found to have moderate . . .