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A right-handed 44-year-old woman presented with a 4-month history of sudden-onset right leg weakness and a 4-week history of small handwriting. On examination, facial expression, blink rate and spontaneous and associative movements were normal. Power in her right leg was mildly reduced proximally with a collapsing, variable nature and she was unable to perform ankle dorsiflexion. Hoover’s sign was positive. She had slight impairment of dexterity in the right arm, but there was no bradykinesia. The stretch reflexes were normal and symmetrical and the plantar responses down going. On pen-and-paper tasks, she had right-sided small script but there was no size decrement, and the Archimedes spiral was small in size with consistent spiral turn spacing (figure 1A, B). MRI brain showed a large left parafalcine meningioma with areas of acute/subacute blood …
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