1. Clinical Reasoning: A 49-Year-Old Woman With Progressive Numbness and Gait Instability
- Author
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Anza Zahid, Yajue Huang, Charles D. Sturgis, Shailee Shah, Courtney A Arment, Jennifer M. Martinez-Thompson, and Divyanshu Dubey
- Subjects
Gait instability ,medicine.medical_specialty ,Nerve Tissue Proteins ,Clinical Reasoning ,Diagnosis, Differential ,Hypesthesia ,Physical medicine and rehabilitation ,Seizures ,Sensation ,medicine ,Humans ,Sensory symptoms ,Medical history ,Neoplasm Invasiveness ,Neoplasm Metastasis ,Gait Disorders, Neurologic ,Burning Pain ,business.industry ,Carcinoma, Ductal, Breast ,Clinical reasoning ,Middle Aged ,medicine.anatomical_structure ,Scalp ,Disease Progression ,Gait imbalance ,Female ,Neurology (clinical) ,business ,Paraneoplastic Syndromes, Nervous System - Abstract
A 49-year-old woman with no relevant medical history presented to an external neurology clinic with progressive hand and foot paresthesia and gait instability for over 6 months. Initially, she reported tingling and shooting electrical-type sensations involving her feet. Within several weeks of the onset of paresthesia, she noted a burning pain sensation involving the left hand. Sensory symptoms continued to worsen and she felt pressure-like sensation around the neck and scalp region. This was shortly followed by right hand numbness and loss of dexterity. Over the next month, she developed progressive gait imbalance and transitioned to a cane for ambulation.
- Published
- 2021