Radha comes to your surgery with her husband.

She says she woke up and her hand felt funny and she had trouble washing her hair and face as her hand felt clumsy. Her husband advises that the left side of her face does not appear normal as it should.You continue to gather more information to further define the problem.

Radha is 35 and was previously well. She awoke with a story of left sided arm and face weakness. There was associated neglect. There was no headache. She now feels well. Radha does not smoke, and is not on the oral contraceptive pill or any other drugs. She is usually well except for migraines which she has had for years. These consist of visual aura and unilateral headaches.

Her past history includes two mid trimester abortions (para 2, gravida 4) and a deep vein thrombosis. Her mother suffered a stroke at the age of 48.