Woman Wakes Up With Bilateral Leg Numbness - Page #1
 

Author: Joshua Cheng, PhD
Co Author #1: Salvatore Capotosto
Co Author #2: Kamalpreet Buttar
Senior Editor: Jessalynn Adam, MD
Editor: Andrew Li-Yung Hing, MD

Patient Presentation:
A 60-year-old woman presented with bilateral leg numbness.

History:
She experienced a one-week history of bilateral leg numbness, which initially presented upon waking. Over the period of a week, he had gradual ascending numbness involving both legs up to the waist. It affected her ability to ambulate and she developed an unsteady gait, with subsequent development of paresthesias in her legs which were most prominent at night. She denied any bowel or bladder incontinence, back pain, neck pain, saddle anesthesia, fevers, night sweats, weight changes, tick bites, rashes or muscle pain.

Physical Exam:
Her systolic blood pressure was elevated to 180, other vitals within normal limits. No paraspinal or spinal tenderness elicited on palpation. Straight leg test was negative bilaterally. Cranial nerves II-XII intact. Motor bulk and tone were intact in all extremities. Strength was 5/5 in all extremities both proximally and distally. Hyperesthesia to palpation below L3/L4. Absent sensation to vibration bilaterally in the toes and ankle joints. Reflexes were 2+ diffusely. Romberg was positive, unsteady gait. Extremities were well perfused with palpable pulses, no edema. No obvious skin rashes present.

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

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