Keywords: Student, Paresthesias, Neurolesions
Paresthesias are abnormal feels along peripheral nerves, the first symptom of temporary or permanent damage of peripheral nerves or disorders of central nervous system, The cause could be orthopedical or neurological. Most often these are musculoskeletal disorders, multiple sclerosis, iron, magnesium or vitamins deficiency.
Student, 24 y.o., BMI 28
Patient‘s both feet feel numb as well as his perianal region. He has diarrhea and constipation for 7 days. He denies a trauma of bone articular system.
PA had hernia surgery as a child, third tonsil, In March 2022. he had problems with sight in his left eye, was examined neurologically. NMR of endocranium was normal. He was examined by orthopedic, radiologist, CT LS, neurosurgeon, while neurological procedure is ongoing. Laboratory tests were within reference values.
Neurological record shows smaller spasm of PVM LS. The right lip angle placed lower, with less visible nasolabial furrow. Discret sinking of the right arm was seen. CT findings old avulsione fracture L4 and L5, aligned physiological lordosis with sinistroconvex scoliosis, protrusion disc at L5/S1 level, polydiscopathy, spondilolisthesis L5. EMNG examination shows chronic to moderate strong neurologic lesions of the roots L5/S1 both sides. Border the value of speed on n. suralis.
Dg. Paresthesia cruris. Sy caudae equine et conus medullaris. Fractura vertebrae L4, L5 obsoleta. Lumboischialgia.
Sy caudae equine was found in our patient, and could explain present health issues. Therapeutic algoritam demands a multidisciplinary approach, treatment of etiological disease and reduction of the symptoms. The patient is advised to maintane a normal activity, to avoid carrying items heavier than 3 kilos and up. He is advised to undergo a physical therapy.
Points for discussion:
To show unspecific neurological symptoms as well as diagnostics procedures that might lead to final diagnosis of rare disease.