[PDF] Top 20 Clinical Reasoning: A unique case of acute onset, progressive left hemiparesis

... the left upper extremity, 3 ⫹ /5 in the left lower ex- tremity, left hemianesthesia, significant dysarthria, and worsening dysphagia, necessitating nasal feeding ... See full document

... an acute dor- sal disc herniation caused a dural defect with subsequent slowly progressive herniation of the cord manifesting with progressive sensory and motor symptoms caudal to the level of ... See full document

... disease (unlikely as it presents with distal upper extremity weakness and atrophy). 1,2 Lesions of the cervical roots (C5- 6) could present in a similar way but lack of neck pain, sensory symptoms, and preserved biceps ... See full document

... quent clinical and MRI ...third acute presentation with nausea, vertigo, right facial numbness, right facial weakness, dysar- thria, right hemiparesis, and right-sided limb ...and left pons ... See full document

... Other than elevated total cholesterol (190 mg/dL) and low-density lipoprotein (130 mg/dL) levels, the evaluation was negative, including negative results for transesophageal echocardiogram, hypercoagulability panel, CSF ... See full document

... CTP demonstrated increased time to drain within the medial aspect of the anterior left frontal lobe. In 1881, Sigmund Exner introduced the concept of handwriting being localized to the medial frontal gyrus. 1 This ... See full document

... causes produce subacute onset of myelopathies and usually affect posterior column sensations. These myelopathies occur in people predisposed to nutritional deficiencies. Different toxic myelopathies have specific ... See full document

... Case 1. A 32-year-old woman with a history of bipolar disorder, polycystic ovarian syndrome, and hypertension and a 4-year history of uncontrolled type 2 diabetes mellitus (DM) presented with bifrontal headache, ... See full document

... after onset, DTR were weakly present, the ptosis had completely resolved, and eye movements remained full ...angle left esotropia was present with improvement of diplopia, continuing treatment with ... See full document

... Her neurologic status progressively worsened over several days. She became oriented only to person and place (not to date), with poor recall. Oculomotor testing revealed slow pursuits with catch-up saccades and ... See full document

... a case of CVST in a woman with APS in the unusual setting of therapeutic antico- agulation and ...Her case was particularly challenging given her concurrent hypercoagulable state and thrombocytopenia, which ... See full document

... and clinical presentation would fit with our patient’s, although for FUS and SOD1 gene mutations the clinical presentation is usually more toward the ALS part of the spectrum and the mean age at ... See full document

... the left median (45 ms at distal site and 50 ms at proximal site) and tibial nerves (47 ms at distal site and 53 ms at proximal site) are consistent with temporal ... See full document

... The effective management of multiple sclerosis is complex and draws on many disciplines, such as neurologists and allied health workers like physiotherapists, occupational and speech therapists, counsellors and social ... See full document

... this case, is that this patient had a unique clinical presentation that demonstrated a sequential pattern of clinical causation which outlined the pathophysiological postulation describing ... See full document

... Silver syndrome is clinically characterized by spas- tic paraparesis, urinary incontinence, distal amyotro- phy/weakness, and often with decreased vibration sense and pes cavus/planus. Onset of symptoms ranges ... See full document

... Pyoderma gangrenosum received this name due to the notion that this disease was related to infections caused by bacteria in the genus Streptococcus. In contrast to this initial assumption, today the disease is thought to ... See full document

... Prior case reports have described both flaccid and spastic paralysis in adults with POWV. 6–8 Around 10% of infections are fatal, with over 50% of patients having permanent neu- rologic deficits, including ... See full document

... Each case not only showed the signs of brain stem encephalitis; two developed ipsilateral weakness and in Case 2 a contralateral hemiparesis.. There was therefore clinical suspicion of c[r] ... See full document

... Focal brain dysfunction without structural abnormalities has been observed in transient ischemic attacks (TIA), migraine, and postictal states. Polymorphic delta activity in these cases may be indistinguishable from that ... See full document