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Showing posts from June, 2024

28M painful polyneuropathy, skin lesions and recurrent quadriparesis, alcoholism

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A 28 yr old male came with chief complaints of: - Weakness of both lower limbs since 15 days - multiple ulcers all over the body since 5 days HOPI: Pt. was apparently asymptomatic 15 days back, then he noticed weakness in both lower limbs when he was trying to wake up in the morning, which was sudden in onset, gradually progressive, associated with b/l limb pains.  H/o difficulty in climbing stairs, standing from sitting position. No h/o difficulty in combing, wearing T shirt, buttoning/unbuttoning. H/o high grade, intermittent fever since 5 days. Associated with chills, generalized weakness. H/o ulcers all over the body since 5 days, initially blisters, later ruptured. No h/o difficulty in coitus Patient then went to local RMP, where he was given Diclofenac and Monocef injections for 3 days.   PAST HISTORY: H/o similar complaints of weakness of both lower limbs 4 times in the past - diagnosed as ?hypokalemic periodic paralysis N/k/c/o DM, HTN, CAD, CVD, epilepsy, thyroid...

65F with Isolated Bilateral Occulomotor Nerve Palsy

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    PRESENTING COMPLAINTS:   A 65 yr old female presented with complaints of inability to open eyes since 1 day   HISTORY OF PRESENTING ILLNESS:   The patient was apparently asymptomatic 1 day back when she developed an inability to open both her eyes which was sudden in onset and static in progression, associated with blurring of vision. Not associated with  diurnal variation,  loss of consciousness, dizziness, chest pain, shortness of breath, palpitations. Right eye adduction and  Right LPS function   improved on day 2.   No h/o  head trauma fall from height, lifting heavy objects on the head/back/ spinal anaesthesia No h/o headache, vomiting, diarrhoea No h/o bed sores, dark coloured urine H/o diminution in vision in right eye since 1 year Not associated with alteration in smell Not associated with colour blindness or night blindness Not associated with facial numbness or inability to chew food Not a...