How To Write A Case Study Distal Axonal Polyneuropathy?

10. What findings in Y.L.'s history place her at increased risk for the development of other forms of neuropathy?

John is in his early forties and has had Type 2 Diabetes for 8 years. When he was first diagnosed, he was offered a diet sheet and advice from his doctor to introduce physical exercise into his life. John is a manual worker and feels he doesn’t need to exercise as he keeps active most of the day. He gave up smoking and drinking alcohol, but after 3 months his blood glucose level was still above normal and was prescribed medication. Eight years later, he now uses insulin to control his blood glucose levels and is a non-smoker. He was admitted to hospital following a road traffic accident which resulted in an operation on his foot which had sustained multiple injuries. The wound was very slow healing and intravenous antibiotics were prescribed.

1. For each of the following diagnostic test results, note which specific part of the brain would have to be damaged to create those symptoms. (include right and left sides in your analysis).

The Consultation Report dated 12/07/2016, indicated that the claimant presented with uncontrolled type 2 diabetes mellitus. He also had a chronic back pain, arthritis, and a history of diabetic neuropathy. His blood sugar was 800 (critical stage). His blood pressure was 129/62 mmHg. The physical examination revealed mild thyromegaly, a decreased air entry at the base of the lungs, and a decreased peripheral palpable pulse. The exam also revealed loss of hair and chronic ischemic changes. Toe deformity and peripheral deformity were noted. He was on Levemir and Novolog. According to the provider, the claimant was on steroids, which has caused an increased blood sugar level. HBA1c

An attending physician statement completed by Dr. Peter Chweyah (Internal Medicine), dated 06/16/2016, indicated that the claimant presented with complaints of lower extremity weakness, neuropathy, weight loss, acute renal failure, and gout, as well as anemia. Objective findings showed an extreme weakness of the legs and pain in the feet. He also had diabetes mellitus type 2, chronic kidney disease, and hypertension. It was noted that the claimant was totally disabled from 05/30/2017 through 06/15/2017 and 05/23/2017 - 05/26/2017 secondary to gout.

DOI: 1/23/2014. This is a 36- year old male relief driver who sustained injury while he was putting away the automatic tarper when he was struck on the right shoulder and got driven into the ground and twisted his right foot. Per OMNI, he was diagnosed with right shoulder strain, and back/neck/right foot fracture. As per office notes dated 6/3/16, the patient is complaining of numbness in all extremities specifically the bilateral feet, arms and bilateral elbows. He has had a flare-up of pain that past couple of weeks around lateral column of the right foot made worse with walking and standing. He has been taking Neurontin 300 mg thrice a day which is helping control his symptoms. He apparently had a bilateral upper extremity upper extremity

Importantly, in any patients with neuropathy and specifically patients with a severe form,it is essential to rule out any other causes apart from diabetes such as ,drug induced neuropathy (e.g. isoniazid) , alcohol abuse, nutritional deficiency like vitamin B12 deficiency(Wile DJ,et al 2010),vasculitis , inherited neuropathies, and renal disease (Freeman R.2009)

Diabetes Mellitus Type 2 with Diabetic Peripheral Neuropathy, Diagnostic Code 250.60, E11.42 – “ Stoke Risk 2-4 Times Higher than Non-diabetics” [5]

Good post! Very informative and well thought out plan of treatment. Diabetic peripheral neuropathy (DPN) occurs in 20% of patients with a diagnosis of diabetes. Along with the complaints that our patient reported in the case study, many patients report deep aching, allodynia worse at nighttime, and paraesthaesia in their lower extremities (Malik, 2012). I agree with your suggested treatment of pain of Gabapentin, including Tramadol and Tylenol. Many people assume that pain should be treated with opioids; however, this presents more challenges. With opioid treatment, there are concerns for addiction, misuse, and adverse effects (Pesa, Meyer, Quock, Rattana, & Mody, 2013). When we are able, I think it is beneficial to prescribe

One of the most common long-term complications of diabetes mellitus is painful neuropathy. Diabetic neuropathy is estimated to affect about 60-70% of all diabetes patients and can lead to foot ulcers, amputations, and decreased quality of life. The most common form is chronic peripheral neuropathy which results in pain and numbness in the extremities, usually described as a burning, tingling, or steady aching pain.1 Patients may also feel increased sensitivity to pain or experience paresthesia, a sensation of tingling, tickling, or prickling of the skin.1 According to current guidelines, intensive glycemic control is very important for the prevention and reduction of peripheral neuropathy and other microvascular complications.1,2 Medications used to help relieve nerve pain include duloxetine and pregabalin (Lyrica®), which are both approved by the U.S. Food and Drug Administration for use in diabetic neuropathy. Other drug classes commonly used are antidepressants, anticonvulsants, and opioids.3 Although there are many medications used for this condition, pain relief is often insufficient for patients. Treatment is difficult due to the complicated pathophysiology of pain transmission and the wide range of mechanisms of action of drugs used to treat pain. Therefore, there is a continued need for additional medication options for this chronic painful condition. Lacosamide is an anticonvulsant approved for use as monotherapy or adjunctive therapy for partial-onset seizures.

Patient name is Stella Baxter , a 93 years old pleasant lady . She worked in a court as clerk from where she retired 35 years ago. She was first hospitalised with a hip fracture in 2013 , later she had undergone a hip surgery . While she was recovering from the surgery , it was found out that she had a left basal ganglia stroke . Her combined diagnoses are Hypertension , Hypothyroidism , Osteoarthritis , Osteoporosis and GERD. She has right side weakness as a result of the stroke.

It has been established that there are at present no adequate forms of preventing CIPN (Cavaletti, 2014). Additionally, CIPN is often under-rated and under-reported particularly as patients do not like to miss treatments (Stubblefield et al., 2009). Therefore, comprehensive evaluations using standardized and sensitive assessment tools to prevent severe neurotoxicity are a critical step for early intervention. According to Stubblefield et al. (2012), it is essential a baseline assessment including any preexisting neuropathy and predisposing factors, such as diabetes, be performed prior to initiation of treatment. This baseline assessment should include not only subjective symptoms, but assessment of strength, reflexes and

Activity limitations for the patient are ambulation and general mobility. As we can see from the table, her lack of upper extremity range of motion has disallowed her to perform overhead activities. Her lower extremity neuropathy accompanied by decreased arthrokinematic mobility and weakness has severely decreased her ability to ambulate. These activity limitations lead to various participation restrictions including; inability to stand for prolonged periods of time, a requirement for her job, and, inability to participate in her usual leisure activities such as dancing and nature walking.

The two components of the central nervous system (CNS) are the brain and the spinal cord. Communication between the brain and the spinal cord happens through motor neurons, which are nerve cells that enable motor movement. Each motor neuron is made up of a cell body, which holds all the cell components, dendrites which send information it receives to the cell body, and an axon which sends nerve impulses to the muscle (Porth & Matfin, 2009). As electrical impulses are sent through the motor neuron, it stimulates the muscle fibers in the body to move. This is the process in which motor function happens. Therefore, the basic abilities to breathe, speak, swallow, walk and button a shirt are

Case Study: A thirty six year old male has developed severe muscle weakness throughout the body. The condition began fifteen months ago with a left foot drop and within a year, he described difficulty with speech and swallowing, muscle twitching and cramping, and muscular atrophy throughout the upper and lower limbs. Within the last two months, his breathing has become more difficult, and there has been a noticeable difference in his voice. Prior to the fifteen months, he presented little to no symptoms. The patient, a medical doctor, has a wife and two young children.