Right Knee Numbness Case Study

He underwent an interlaminar injection in May 2015 which improved his lower extremity pain by 99%. This has lasted him up until 1 month when he has had recrudescences of pain emanating from the low back radiating intermittently into the left lower extremity in a sharp shooting fashion, average pain 5/10, and worse pain 81/0. The pain is frequent and is associated with numbness and tingling. There is some difficulty with walking. Over the past 1 month, the pain has been severe. Home exercises and nonsteroidal anti-inflammatory medications (NSAIDS) have not been effective in reducing his pain and the pain is severe at times and limiting his ability to lift and sit. Walking, exercise and standing increased the pain. Lying down reduce the

7. What other findings indicative of central nervous system (CNS) involvement from SLE should D.W. be assessed

Patient is a 50-year-old-year-old left-handed white male who presents with his wife for evaluation of multiple symptoms that have been present since an MVA in 02/2013. At that time, he was T. boned and his car was totaled. He has amnesia for the event and is unaware whether or not he hit his head. The airbag did deploy. Afterwards, he was confused and noted significant pain in his neck and upper back. Since then, he has had multiple symptoms. He does have involuntary twitching on the right, more than left, both hands, legs, and sometimes feet. He demonstrates one of these twitches and it looks like a focal myoclonic jerk of a limb. These occur on a daily basis. He also has problems with his left thumb and index finger locking up. When he is fatigued, especially when his neck gets tight, he has some problems with word finding, paraphasic errors, and syntax errors. He did see Anthony P. Knox,

years ago with vague complaints of (C/O) intermittent fatigue, joint pain, low-grade fever, and unintentional

This operation did not stop the pain, even after many months of rest, more infiltrations and thermos coagulation burning of the nerve roots . He then tried acupuncture which did not calm the pain. He is now using homeopathy for the nerve system, and this helps enormously and has allowed him to start working again. Do you think there could be any connection between the shingles as a boy and these stabbing pains that he has been having overall these years Could the nerve have been damaged Answer The location of the pain certainly makes one think of shingles. Since the virus that causes shingles remains permanently in those nerves, it seems possible to me that some kind of chronic neuritis is possible. There is no true cure for this virus, though outbreaks can sometimes be helped by gamma globulin or immune sera from people with chickenpox or some antiviral drugs. If the homeopathic cure is helping, that is a blessing. Hopefully it will continue to work and whatever the cause, your husband will at least feel some

Upon assessment, I found that both her lower legs had +1 edema, were red, skin was a bit peeling, and warm to touch. She reported a bit of tenderness on palpation. The right leg, however, had black “scabs” towards the outer side; upon palpation, I noticed that they were under the skin and I could not feel any bumps. Other than her lower legs, her skin was dry and intact, color consistent with her ethnicity, no surgical incisions, and mucous membranes were pink, moist, and intact. She had a #22 IV in her left hand, and the IV site was clean. She was oriented x3, calm and cooperative, had clear speech, had no weakness, no flaccid tone, and no numbness. Her strength was normal in upper extremity, and her lower extremities moved against resistance. Her pupils were round, equal in size, and reactive to light. Her blood pressure was 133/76, heart rate 94, oxygen saturation of 98% on room air, respiratory rate of 18, oral temperature of 36.7

Per the Agreed Medical Re-Examination report dated 09/29/15, whole person impairment rating is 5%. Future medical care includes access to follow-up visits for monitoring of his condition for the next calendar year, with continued provision of pharmacological agents. Should patient experience a significant acute symptoms flare-up within the next calendar year, re-instatement of brief courses of traditional PT, acupuncture,

He still does have significant amount of residual back pain. Also, he does get still intermittent pain and numbness in the legs, left side worse than the right side. He also gets bilateral knee pain. He continues to have some bladder incontinence episode urgency. He does feel depressed as well. Treatments to date include anti-inflammatory medications, physical therapy, epidural injection performed in May 2015, spinal surgery in 2011, L4-L5 laminotomy with good improvement, and left L5-S1 laminotomy on 4/20/16 with improvement postoperative. Physical examination revealed that the patient has been able to discontinue the use of cane. There is pain to palpation over the L5-S1 area. Range of motion is limited. The patient has flexion of 60% of normal and extension of 40% of normal. Motor strength is 5-/5 in the left lower extremity, especially in the gastrocsoleus and extensor hallucis longus. Sensation is slightly diminished in the L5 distribution bilaterally, left worse than the right. Deep tendon reflexes is 2+ at the bilateral knee and 1 + at the bilateral ankle. Plan notes physical therapy of 2 x/ week to strengthen muscles, stabilize the spine and reduce pain; Flector patch 1.3% to be applied one patch to the back every 12 hours as necessary for

I did receive a significant amount of records from this patient's PCP, as well as neurology consult in followup and infectious disease notes. In short, he is a 67-year-old right-handed white male who while living in Alaska developed some hip pain, as well as medial right hand numbness. He did have an EMG on 10/2000 that showed ulnar neuropathy with cubital tunnel syndrome on the right. Ulnar nerve transposition was considered, but the patient deferred this. He did have an MRI of the cervical spine, which revealed most significantly C3-4, moderate bilateral neuroforaminal narrowing, C4-5 severe left and moderate right neuroforaminal narrowing, C5-6 severe bilateral neuroforaminal narrowing. He did

In the last three weeks my client G was experiencing tingling in his hands, decreased fine motor control in his hands and increased weakness in his back and legs. This all led to decreased mobility and he was not in a wheel chair with limited ambulation (transferring to and from his bed or toilet and walking with PT two times day). This was a drastic change to his ability to care for himself and move about freely. This was impacting his emotionally and physically. Gas expressed embarrassment of having someone to help his to use the toilet and bath him. Due to his decreased mobility and spinal damage, he was losing strength, possibly at risk embolism and

They may develop alone or in combination, but as the disease progresses, all are usually present. There is no true paralysis. The symptoms are always bilateral but usually involve one side early in the illness. Because the onset is insidious, the beginning of symptoms is difficult to document. Early in the disease, reflex status, sensory status, and mental status usually are normal. Postural abnormalities (flexed, forward leaning), difficulty walking, and weakness develop. Speech may be slurred. Autonomic-neuroendocrine symptoms include inappropriate diaphoresis, orthostatic hypotension, drooling, gastric retention, constipation, and urinary retention. Depression is also prevalent.

Patient is an 86-year-old right-handed white female who is a poor historian. She states she saw me several years ago, but cannot recall for what. She did see Geoffrey Starr, MD in 2011 for episodes of numbness and tingling in the right side of her cheek. He did a workup, which included the EEG, EMG, and carotid studies. She was complaining of some right upper extremity and left lower extremity numbness and tingling as well. These were all negative. Her PCP switched her from aspirin 81 mg to Plavix 75 mg. Dr. Starr added Trental to that. The patient states that over the years, she continued to have the numbness and tingling episodes of the right side of her face. The last several seconds at times, rarely

The patient is an 80-year-old right-handed white female, who presents with her male partner for evaluation of left lower extremity symptoms. She did present for an EMG nerve conduction study in May. At that time, she gave a history of intermittent numbness into the anterior lateral thigh. The numbness rarely extended below the knee at that time, and it rarely occurred on the right. There was no clear radicular component. Her exam was normal. Her EMG of the left lower extremity was limited because she is on Pradaxa, but it was normal and CBs were consistent with a mild motor neuropathy. The diagnosis was possible meralgia paresthetica. The patient now states that the numbness is intermittent. It is on the anterior thigh, but now it goes down into the calf anteriorly and

The first symptoms of this ailment include variable degrees of weakness or tingling feelings in the legs. In many cases, the weakness and uncharacteristic sensations spread to the arms and upper body.

Per medical report dated 10/26/15 by Dr. Parsioon, the patient was initially seen on 9/14/15 for evaluation and treatment of cervical pain. At that time, he had neck pain without radiculopathy and bilateral hand tingling. IW stated that physical therapy made his neck pain increase and he wanted to make sure that it is okay to continue this. His chief complaint is pain in his neck radiating to the right shoulder and arm. He states the only time he gets the tingling sensation in the hand is