A never forgotten differential diagnosis of monoparesis.

A 58-year-old gentleman presented with gradually progressive left hand weakness for one year. Left leg dragging and dysarthria developed 3months before visiting our neurology clinics. Neurological examination revealed muscle atrophy without fasciculation in the left first dorsal interosseous and triceps brachii muscles. Left spastic hemiparesis with exaggerated jaw jerk and flaccid dysarthria were noted. MRI (figure) showed a lobulated circumscribed mass in right high convexity with inhomogeneous enhancement and dural tail. Meningioma was diagnosed. Left hemiparesis improved gradually after tumor excision. Brain tumor is a rare but never forgotten differential diagnosis of monoparesis.