2 CASE HISTORY/EXAMINATION
A 68-year-old female patient, functional class I, with no known
comorbidities. presented to the emergency department with left arm pain
and progressive weakness, along with left leg pain for one and a half
months. No preceding respiratory or gastrointestinal symptoms were
reported. Her family history was unremarkable, and she denied using
tobacco, alcohol, or other drugs. In addition, there was no history of
gastrointestinal disorders, weight loss, diabetes, ischemic heart
disease, or thyroid disorders. On examination, the patient was pale with
no associated jaundice or lymphadenopathy. She was in sinus tachycardia
with a B.P of 183/109 and was afebrile.
On neurologic examination, left upper limb power was 2/5 with claw hand
and associated tremors. The lower limb power on the left was 4/5 with
normal tone. Power and tone on the right side were normal. Higher
neurological functions were normal and bilateral Babinski sign was
negative. Rest of the systemic examination was unremarkable.