Case study presented by Mike Huntington and Andrew Ritchison
Patient History
The patient is a 47-year-old female who presented with the complaint of a two-day history of difficulty in expressing herself and problems with concentration and short-term memory. She also described a one and one-half year history of progressive bilateral extremity numbness and gait difficulty. Her symptoms were of gradual onset, and included numbness and intermittent tingling in her hands and feet. Her gait difficulty was described as "unsteadiness" that worsened in the dark. She had been walking with the assistance of a walker for 6 months.
She also reported an episodic shooting pain that started in her neck and passed down her back and into both arms. She denied any history of previous trauma, diplopia, dysphagia, vertigo, vision loss, loss of consciousness, back pain, or symptoms of bowel or bladder dysfunction.
Family history was negative for neurological disease. Her medications included only an occasional anti-inflammatory drug for neck pain. Social history revealed a one-half pack per day history of tobacco use, social alcohol ingestion, and no illicit drug use. She was single and worked as a security dispatcher.
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