Pathologic reflexes and cerebellar symptoms are

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the dorsal area of first interdigital space on the right hand is observed. Pathologic reflexes and cerebellar symptoms are absent. What is your diagnosis? Describe algorithm of diagnosis and treatment. Diagnosis: radial nerve palsy 39
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Algorithm of diagnosis: nerve conduction velocity test, X-ray of the humerus in the zone of fracture to check for bone defects that might have caused the palsy Treatment: splinting of the wrist, physical, occupational therapy 4 Patient, 42 years old, female, was admitted to neurological department due to complaints of dumb pains, paresthesias, weakness in legs, especially in distal portions and difficulty during walk. This state has started 3 weeks ago and has been slowly progressing. During last 1 year woman noted thirst, intensive urination, during prophylactic visit to out-patient department increased level of blood glucose (11,2 mmol/l) was revealed. Patient didn't received regular treatment. Her vital parameters: BP – 125/85 mm Hg, pulse – 79 beats/sec., breath rate – 14/sec. During neurological examination next signs were revealed – decrease of the muscular strength in feet, absence of the tendon reflexes on distal portions of legs, decrease of pain, temperature and muscle-and-joint sensation there as well as on hands. During Romberg’s test some mild swaying is observed. What is your diagnosis? Describe algorithm of diagnosis and treatment. Diagnosis: diabetic polyneuropathy Algorithm of diagnosis: Nerve conduction tests may show reduced functioning of the peripheral nerves Treatment – control over diabetes, pain control: antidepressant duloxetine and the anticonvulsant pregabalin α-lipoic-acid to stimulate regeneration of myelin sheath 5 Patient, 41 years old, male, consults neurologist due to complaints of low back pain, pain on posterior-lateral surface of the right thigh and shin, weakness of the right foot. Pain is increased during motions and sitting, decreased during lying supine. Such symptoms have been observed during last 10 years. For the first time pain occurred after the lifting of heavy weight, when something «cracked» in lumbal area – then patient was unable to assume erect position. In 2 days after the treatment with pain-killers health condition was stabilized. Such pain developed subsequently 3 times. 10 days before consultation man almost slipped on the ice but was able to keep balance. In 20 minutes pain appeared again, became stronger closer to the evening, in 2 days started referring to right leg, in 1 day more weakness occurred. Somatic examination is unremarkabe. His vital parameters: BP – 130/86 mm Hg, pulse – 78 beats/sec., breath rate – 13/sec. During neurological examination next signs were revealed – limited mibility in lumbar area and right ankle. Muscular strength in right foot, especially in greater toe, is decreased. Knee jerks are preserved and symmetric, right Achilles' reflex is lost. Paravertebral points are tender during palpation. Positive Neri's and Laseg's signs, hypesthesia of the pain sensation at the lateral surface of right shin and dorsal surface of right foot, especially in area of IV-V toes.
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  • Winter '18
  • Jane doe
  • Neurology, Seizure, Seizure types

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