Football Practice Took The Strength Right Out Of Me - Page #1
 

Author: Chenai Nettey, MD
Co Author #1: Daniel Murphy, MD, FAAFP
Co Author #2: Colby Genrich, MD
Co Author #3: Justin Wright, MD, FAAFP
Senior Editor: Yaowen Hu, MD, MBA
Editor: Ruikang (Kong Kong) Liu, MD
Editor: Phillip Ribbeck, MD

Patient Presentation:
19 year old football player presents with symptoms of fatigue and weakness.

History:
Patient was diagnosed with practice fatigue by the athletic trainer the day before. He had worsening symptoms at home and so was evaluated in the athletic training room by the Sports Medicine physician the next day. He was found to have weakness and poor coordination of his left arm and left leg. He described symptoms of drowsiness, feeling "slow," and difficulty concentrating. His mother noted mood swings since the onset of symptoms. Review of systems was positive for headache and negative for blurry vision, dyspnea, swelling of the extremities, muscle/joint pain, urinary or bowel changes, or skin discoloration.

Past medical history was significant for migraines and an episode of leg swelling 1 month ago with ultrasound negative for DVT. Past surgical history included a right ACL tear and reconstruction 10 months ago and revision 3 months after the initial surgery. He does not take any medications other than over the counter NSAIDs. There was no significant family history, and he denied any drug use.

Physical Exam:
Patient was in no acute distress with a normal cardiopulmonary exam. His extremities were non-tender and without swelling. Neurologic exam was significant for left facial droop, 4/5 weakness with strength testing on the left arm and left leg with dysdiadochokinesia, hyperreflexia of the left biceps and patellar tendon reflexes, and positive Romberg. He had difficulty with tandem gait with eyes open and was unable to do it with eyes closed. Pupils were equal, round, and reactive to light, and saccades and vestibulo-ocular motor reflexes were both intact. Sensation was intact in all extremities. Mental status exam including alertness/orientation, 3 word recall (immediate and after 10min), serial 7s, reverse alphabet, and language were all normal.

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NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415


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