Main Case

Август 20, 2022

Содержание

2. History Previously healthy 34-year-old right-handed woman. Mexico city resident. Housewife. Non-smoker. Past medical history: Uneventful cesarean
3. Presentation Sudden onset dysarthria Progressive dysphagia, sialorrhea, and bilateral hand weakness Presented to the Emergency Department
4. Neurological examination Vital signs: BP: 112/75 mmHg, BR: 14 bpm, HR: 76 bpm, Temperature: 97.7 °F
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Слайд 2

History
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 3

Presentation
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 4

Neurological 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.