Case 33-1973

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Abstract
Presentation of CaseA 77-year-old man was admitted to the hospital because of weakness.Five years previously congestive heart failure occurred, and atrial fibrillation was found. There was a single episode of difficulty in speaking that cleared after one week. For several years he had experienced intermittent Raynaud's phenomenon. Six months before entry dysphagia and constipation developed, and he lost 9 kg in weight, together with a decrease in peripheral edema. One month before admission there was the sudden onset of diplopia. There were episodes of numbness of the right side of the face and of the tongue, his voice . . .
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