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Clinical Reasoning: A 27-year-old man with acute-onset ataxia

Clinical Reasoning: A 27-year-old man with acute-onset ataxia

Authors :
Menachem Weiss
Jorge Risco
Source :
Neurology. 88:e207-e211
Publication Year :
2017
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2017.

Abstract

A 27-year-old man with a history of diabetes mellitus (DM) and asthma presented to the emergency department 1 month after the onset of dysarthria and ataxia. The symptoms were noted abruptly upon waking. He swayed on standing, fell easily, and noted tremor when manipulating objects. His speech was nearly unintelligible. He also had 1 month of mild distal paresthesias and a 30-pound unintentional weight loss. He denied diplopia, dysphagia, preceding illness, or other systemic symptoms. Over the course of the month, his dysarthria improved but his imbalance remained unchanged. His delay in seeking medical attention was due to lack of health insurance. The authors thank Michel J. Berg, MD, Department of Neurology, University of Rochester Medical Center, and Melissa Tsuboyama, MD, Department of Child Neurology, University of Rochester Medical Center, for reviewing the manuscript.

Details

ISSN :
1526632X and 00283878
Volume :
88
Database :
OpenAIRE
Journal :
Neurology
Accession number :
edsair.doi.dedup.....c6265f9511fb451f31e85f7170f17b74
Full Text :
https://doi.org/10.1212/wnl.0000000000003986