One-and-a-half spectrum syndrome

A man in his 40s had a 12-hour history of diplopia with worsening right arm and leg weakness. He then developed left-sided facial droop and slurred speech. He had suboptimally controlled vascular risk factors, including an initial blood pressure of 200/110 mmHg, an glycated haemoglobin of 102 mmol/mol (20–42) and serum low-density lipoprotein cholesterol of 4.5 mmol/L (<3.36).