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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
- 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.
- Subjects :
- Adult
Male
Pediatrics
medicine.medical_specialty
Neurology
Ataxia
Cerebellar Ataxia
030218 nuclear medicine & medical imaging
03 medical and health sciences
Dysarthria
0302 clinical medicine
Weight loss
Pons
medicine
Humans
Insulin
Diplopia
business.industry
Clinical reasoning
Emergency department
Dysphagia
humanities
Acute Disease
Myelinolysis, Central Pontine
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Demyelinating Diseases
Subjects
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