A 70 year-old male, with a past medical history of hypertension, gastroesophageal reflux disease, chronic lymphocytic leukemia on Ibrutinib, and coronary artery disease, presented with right hand weakness since waking that morning. He reported that he felt the strength of his grip was not at baseline, and his wife also noted that, while eating breakfast, the patient dropped his bagel, a dish towel, and his utensils. His last known well was 10:00 PM the night before, although he also endorsed two weeks of persistent right hand numbness and burning paresthesias in his right hand. He denied headache, fever/chills, chest/back/abdominal pain, nausea/vomiting, urinary symptoms, or diarrhea, as well as any visual symptoms, speech changes, or gait problems…
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