Scribd
Upload
36 views2 pages

neurological case studies 2

The document presents two case studies of patients with sudden onset neurological symptoms. The first case involves an 81-year-old woman with left foot weakness, likely indicating a lesion in the left hemisphere, possibly due to a stroke, given her history of hypertension and diabetes. The second case describes a 31-year-old woman with left-sided weakness and coordination issues, suggesting a lesion in the right hemisphere, with potential diagnoses including a transient ischemic attack or multiple sclerosis.

Uploaded by

gilessharman
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
36 views2 pages

neurological case studies 2

The document presents two case studies of patients with sudden onset neurological symptoms. The first case involves an 81-year-old woman with left foot weakness, likely indicating a lesion in the left hemisphere, possibly due to a stroke, given her history of hypertension and diabetes. The second case describes a 31-year-old woman with left-sided weakness and coordination issues, suggesting a lesion in the right hemisphere, with potential diagnoses including a transient ischemic attack or multiple sclerosis.

Uploaded by

gilessharman
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 2

Case Study 2

1. Sudden Onset of Left Foot Weakness

Chief Complaint: 81-year-old woman presented to the emergency room because of left
foot weakness.

History: The patient was previously healthy except for a history of hypertension and
diabetes. On the morning of admission, as she got out of bed she noticed difficulty when
she first put her left foot on the floor. As she tried to walk, she felt that she was dragging
her left foot. Nevertheless, she continued her usual morning activities, using a chair for
support. Later in the morning, when the gait difficulty persisted, she called her children,
who brought her to the emergency room. She had no other complaints except for a mild
right frontal headache.

Physical Examination:
Vital Signs: Not recorded on admission
Neck: Supple with no bruits.
Lungs: Clear.
Heart: Regular rate, with soft systolic murmur.
Abdomen: Benign, with normal bowel sounds.
Extremities: Normal

Neurologic exam:
Mental Status: Alert and oriented. Speech fluent, with intact naming and comprehension.
Cranial Nerves: Normal including no facial weakness.
Motor: No pronator drift. Normal tone. Power normal throughout, except for left foot and
leg: left iliopsoas and hamstrings weakened, left ankle dorsiflexion and extensor
hallucis longus weakened.
Reflexes: Normal.
Coordination and gait: Normal except for slowing of heel-to-shin testing with left leg.
Gait not tested.
Sensory: Intact light touch, temperature, joint position, and vibration sense.

Be sure to answer the following in your assessment:


1. On the basis of the symptoms and signs shown in bold where is the lesion?

2. Given the sudden onset of symptoms in an elderly patient with diabetes and
hypertension, what is the most likely diagnosis? What are some other possibilities?
2. Pure Motor Hemiparesis
Chief Complaint: A 31-year-old woman developed left face, arm, and leg weakness.

History: Three days prior to admission, while on a business trip, the patient noticed some
difficulty walking, veering slightly to the left and bumping into corners and walls on
her left side. The next day she had some stuttering of her speech, which subsequently
resolved. She returned home, and on the morning of admission she noticed that her left
arm and hand were somewhat weak and clumsy. She did not have any sensory
symptoms, visual problems, headaches, or changes in bowel or bladder function. Her
symptoms worsened in a warm meeting room and improved with a cold shower.

Physical Examination:
Vital Signs: T = 98.4˚F, P = 85, BP = 132/81, R = 20
Neck: Supple.
Lungs: Clear.
Heart: Regular rate with no murmurs.
Abdomen: Normal bowel sounds; soft, nontender.
Extremities: Normal.

Neurologic exam:
Mental Status: Alert and oriented. Recalled 2/3 words after 5 minutes. Speech fluent,
with intact comprehension and repetition. No neglect on drawing a clock face or line
cancellation tasks. Normal abstraction judgment.
Cranial Nerves: Normal except for a decreased left nasolabial fold. No dysarthria on
exam. Fundi normal.
Motor: No pronator drift. Tone slightly increased in left arm. Rapid finger tapping
slower on left. Power reduced in left deltoid, triceps, iliopsoas, quadriceps, and
hamstrings. Otherwise power was normal throughout.
Reflexes: Increased reflexes on left side.
Coordination: Normal finger-to-nose testing bilaterally.
Gait: Tends to veer to the left, especially with eyes closed. Decreased arm swing on the
left. Unsteady tandem gait, falling to the left.
Sensory: Intact light touch, pinprick, temperature, vibration, and joint position sense.

Be sure to answer the following in your assessment:


1. On the basis of the symptoms and signs in bold above where is the lesion?

2. What is the most likely diagnosis? What are some other possibilities?

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy