Neuropathy: Practice Cases
Patient 1: Clay—Pins and needles Tap the arrow to view the case.A 35-year-old rancher who breeds cattle presents to your clinic a week after being hospitalized for upper and lower extremity sensory changes and weakness. His symptoms began about three months ago, initially as numbness and “pins and needles” tingling in both of his feet, […]
Charcot-Marie-Tooth Disease: Hereditary Motor and Sensory Neuropathy
Author Blake Cohoe, MD editor Dawn DeWitt, MC, MSc, MACP, FRACP Hereditary motor and sensory neuropathy Question Hereditary motor-sensory neuropathy (HMSN) primarily affects the peripheral nervous system. Which of the following are features of the most common type of HMSN? Other answers ALS: Death of both upper and lower motor neurons in the motor cortex […]
Case Study 2: My Feet Are Numb
Case study 2: Manu—My feet are numb Tap the image to view the case. A 65-year-old man sees you to discuss progressive numbness and tingling in his feet. He first noticed the numbness a few months ago, but at that time it was only in his toes. The patient says he thought it was just […]
Case Study 1: Increasing Weakness
Case study 1: Manuel—Increasing weakness Tap the image to view the case. A 24-year-old man presents to his primary care provider with his mother for an urgent appointment due to increasing weakness during the past week. The patient says he had a “stomach bug” two weeks ago after attending an outdoor BBQ, and initially attributed […]
6. Peripheral Neuropathy
Authors Keely Coxon, MD Dawn DeWitt, MD In this module Peripheral nerves Role: Carry sensory and motor information between the brain/spinal cord (central nervous system (CNS)) and the rest of the body. Each peripheral nerve is individually myelinated, produced by Schwann cells (vs. oligodendrocytes in CNS). Types of peripheral nerves Motor nerves* Sensory nerves* Autonomic […]
References
Websites Stroke symptoms: From fast to faster. Beaumont Health. May, 12, 2016. About Stroke. Centers for Disease Control and Prevention. (2022, April 5). Books and articles Musuka, Tapuwa D et al., Diagnosis and management of acute ischemic stroke: speed is critical. CMAJ: Canadian Medical Association journal = journal de l’Association medicale canadienne vol. 187,12 (2015): […]
Knowledge Check
While this knowledge check is “open book,” the best way to learn is to practice spaced-repetition “free recall,” so try to answer these without looking. Match the following with the terms below. Blood Pressure contraindication for administration of thrombolytics. Preferred blood pressure medication(s) to lower BP in acute stroke if needed. Medication recommended for secondary […]
Case Study 2: Couldn’t Raise Left Hand
Case study 2: Joe—Couldn’t raise left hand and arm Tap the image to view the case. A 72-year-old male is brought into the ER by ambulance after he could not pick up his mug of coffee using his left hand. His wife said he tried to pick up the mug, but couldn’t raise his hand […]
Case Study 1: Facial Droop and Slurred Speech
Case study 1: Margaret—Facial droop and slurred speech Tap the image to view the case. An 85-year-old woman is brought into the ED after she was found to have a right-sided facial droop and slurred speech. She is difficult to understand, but describes numbness in her right forearm and hand, which she noticed “a couple […]
5. Stroke
Authors Keely Coxon, MD Michael Chun, MD Dawn Dewitt, MD In this module Act FAST! The National Stroke Association and National Heart Association have used the acronym “FAST” as a public health tool for many years. Anyone with the following signs/symptoms is encouraged to call EMS or go to the emergency room for evaluation. BE […]