A 64-year-old man presented to the Department of Neurology with recurrent head discomfort for over eight years and right-side facial and limb atrophy for five years. The head discomfort usually lasted for hours and was accompanied by paroxysmal palpitation, which worsened with head movement or bending but was relieved by lying down. He had a history of ankylosing spondylitis for 50 years. No family history was reported. Neurological examination revealed atrophy in his right face and limb (Fig. 1).
