Author: Michael Grasic, MD
Co Author #1: Hamish Kerr, MD, MSc
Co Author #2: Todd Shatynski, MD
Senior Editor: Kristine Karlson, MD, FAMSSM
Editor: Christine Persaud, MD

Patient Presentation:
31-year-old male presented to the clinic with left lower extremity numbness, tingling, and foot drop.

History:
His symptoms gradually appeared approximately 2 months ago. He denied any injury or trauma. He noted that his symptoms started around the same time he was experiencing increased anxiety due to personal life events. He mentioned that during this difficult time, he would sit for multiple hours at his desk with his legs crossed. He initially noticed numbness and tingling in his left anterolateral shin, which resolved later that day. Throughout the following week, the intermittent symptoms he was experiencing progressed to constant anterolateral shin numbness and tingling, as well as a left foot drop. The complete distribution of his numbness included anterolateral left shin numbness, dorsal left foot numbness, as well as numbness in between his first and second left digits. He complained of inability to fully dorsiflex his left foot due to weakness.

Physical Exam:
Left lower extremity: No swelling, ecchymosis or deformity. No evidence of crepitus, effusion or tenderness. Tingling sensation with palpation over the anterolateral shin, dorsal of the foot and between the first and second webspace. Patellar reflexes 2+ and symmetrical. Full range of motion of the knee in active flexion and extension. Limited range of motion of the ankle with active dorsiflexion and inversion. Full passive range of motion. 5/5 strength on plantarflexion and eversion of ankle bilaterally. 2/5 strength on dorsiflexion. High steppage gait.
Lumbar spine: Full ROM, well aligned, no tenderness on palpation, no erythema noted, negative straight leg raise.

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