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 […]

References

Download 2017 McDonald Criteria Download Practice Guideline: Disease-modifying Therapies for Adults with Multiple Sclerosis

Knowledge Check

Question Check your answer Use your favorite resource to verify your answers. Peripheral neuropathy: Where does it start and why, after X body parts, what is affected next (and why)? Review and write down: Brown-Séquard pattern. Syringomyelia pattern. Spaced repetition recallWhat is affected in: Hemispheric stroke (e.g., R MCA stroke)? Brainstem stroke (e.g., L vertebral […]