RT Journal
A1 Foley K
T1 A 44-year-old woman with severe pain at the end of life
JF JAMA
JO JAMA
YR 1999
FD May 26
VO 281
IS 20
SP 1937
OP 1945
DO 10.1001/jama.281.20.1937
UL http://dx.doi.org/10.1001/jama.281.20.1937
AB 
Mrs L experienced a flaccid left arm for 5 days prior to admission—the
first manifestation of metastatic lung cancer. She also noted some mild
weakness in the left leg accompanied by slurred speech and some
drooling. There was no associated headache, change in vision, fever, or
weight loss. She complained of mild shortness of breath and back pain.
Her medical history is complex and notable for a seizure disorder since
age 16 years, polycythemia vera, hemiplegic migraine, carcinoid,
colitis, pseudotumor cerebri, and distal pancreatectomy for islet cell
tumor.