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Main Case
Содержание
- 1. Main Case
- 2. HistoryPreviously healthy 34-year-old right-handed woman.Mexico city resident.Housewife.Non-smoker.Past
- 3. PresentationSudden onset dysarthria Progressive dysphagia, sialorrhea, and
- 4. Neurological examinationVital signs: BP: 112/75 mmHg, BR:
- 5. Neurological examination
- 6. Скачать презентанцию
HistoryPreviously healthy 34-year-old right-handed woman.Mexico city resident.Housewife.Non-smoker.Past medical history:Uneventful cesarean section one month before admission.Allergies, substance abuse, use of contraceptive drugs, and history of abortions were denied.No recent history of vaccination.Family
Слайды и текст этой презентации
Слайд 1Main Case
NIRVE Rounds
Miguel García-Grimshaw
PGY-6 Neurology Resident
National Institute of Medical Science
and Nutrition Salvador Zubiran, Mexico City
Слайд 2History
Previously healthy 34-year-old right-handed woman.
Mexico city resident.
Housewife.
Non-smoker.
Past medical history:
Uneventful cesarean
section one month before admission.
Allergies, substance abuse, use of contraceptive
drugs, and history of abortions were denied.No recent history of vaccination.
Family history:
There was no family history of chronic, systemic, infectious, or neurological diseases.
Слайд 3Presentation
Sudden onset dysarthria
Progressive dysphagia, sialorrhea, and bilateral hand weakness
Presented
to the Emergency Department with anarthria.
03/10/2019
03/11/2019
03/15/2019
Relevant negatives: Fever, vertigo, headache,
altered mental status, visual or sensory disturbance
Слайд 4Neurological examination
Vital signs: BP: 112/75 mmHg, BR: 14 bpm, HR:
76 bpm, Temperature: 97.7 °F (36.5 °c), SpO2 on room
air 98%.Mental status: Alert and orientated.
Language: Anarthric, auditory, and reading comprehension were intact, able to communicate with signs and by handwriting.
Reading comprehension was evaluated by asking the patient to follow written orders and tasks.
Cranial nerves: (Video will be presented)
V: Sensory: Normal; Motor: Limited mouth opening and unable to make lateral movements of the jaw. Absent jaw jerk reflex.
VII: Bilateral central facial diplegia.
IX and X: Unable to swallow with a bilateral normal gag reflex.
XII: Unable to protrude or make lateral movements of the tongue.
Cerebellum: Normal.
Extrapyramidal signs: None.
Gait: Normal.
Abnormal movements: None.
Prominent automatic-voluntary dissociation, characterized by preserved yawning and smiling.
