Case 19-2017 — A 53-Year-Old Woman with Leg Numbness and Weakness
A 53-year-old woman was admitted to the hospital because of progressive asymmetric hypoesthesia and weakness in the legs. Urinary retention, absence of rectal tone, and saddle anesthesia developed. A diagnostic test was performed. Presentation of Case Dr. Kristyn M. Spera (Neurology): A 53-year-old...
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| Veröffentlicht in: | The New England journal of medicine 2017-06, Vol.376 (25), p.2471-2481 |
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| creator | David, William S Bowley, Michael P Mehan, William A Shin, John H Gerstner, Elizabeth R DeWitt, John C |
| description | A 53-year-old woman was admitted to the hospital because of progressive asymmetric hypoesthesia and weakness in the legs. Urinary retention, absence of rectal tone, and saddle anesthesia developed. A diagnostic test was performed.
Presentation of Case
Dr. Kristyn M. Spera
(Neurology): A 53-year-old woman with rheumatoid arthritis was admitted to this hospital because of progressive asymmetric hypoesthesia and weakness in the legs.
The patient had been in her usual health until 4 months before this admission, when hypoesthesia developed in the lateral aspect of the left foot. During the following 2 days, the hypoesthesia spread to involve the toes and midfoot. On evaluation by her primary care physician, the patient reported that her chronic low-back pain, which radiated to the buttocks, had increased in intensity, but there was no pain in the legs, . . . |
| doi_str_mv | 10.1056/NEJMcpc1701762 |
| format | Article |
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Presentation of Case
Dr. Kristyn M. Spera
(Neurology): A 53-year-old woman with rheumatoid arthritis was admitted to this hospital because of progressive asymmetric hypoesthesia and weakness in the legs.
The patient had been in her usual health until 4 months before this admission, when hypoesthesia developed in the lateral aspect of the left foot. During the following 2 days, the hypoesthesia spread to involve the toes and midfoot. On evaluation by her primary care physician, the patient reported that her chronic low-back pain, which radiated to the buttocks, had increased in intensity, but there was no pain in the legs, . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMcpc1701762</identifier><identifier>PMID: 28636859</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>Anesthesia ; Bladder ; Brain - diagnostic imaging ; Brain - pathology ; Cancer ; Case reports ; Cerebrospinal Fluid - chemistry ; Cerebrospinal Fluid - cytology ; Diagnosis, Differential ; Electromyography ; Female ; Humans ; Hypesthesia - etiology ; Leg ; Legs ; Lumbar Vertebrae - diagnostic imaging ; Lymphoma ; Lymphoma, Large B-Cell, Diffuse - complications ; Lymphoma, Large B-Cell, Diffuse - diagnostic imaging ; Lymphoma, Large B-Cell, Diffuse - pathology ; Magnetic Resonance Imaging ; Medical diagnosis ; Middle Aged ; Muscle Weakness - etiology ; Nervous system ; Neurology ; Neurosurgery ; NMR ; Nuclear magnetic resonance ; Pain ; Peripheral Nervous System - anatomy & histology ; Peripheral Nervous System - physiology ; Rectum ; Rheumatoid arthritis ; Sarcoidosis - diagnosis ; Spinal Nerve Roots - pathology ; Stem cells ; Tuberculosis - diagnosis ; Womens health</subject><ispartof>The New England journal of medicine, 2017-06, Vol.376 (25), p.2471-2481</ispartof><rights>Copyright © 2017 Massachusetts Medical Society. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c354t-3d6fa6cce4b2c81f9fc13d968bb59d22db1032eaacec6eba9377fc148edd1d873</citedby><cites>FETCH-LOGICAL-c354t-3d6fa6cce4b2c81f9fc13d968bb59d22db1032eaacec6eba9377fc148edd1d873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMcpc1701762$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1931796839?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>309,310,314,780,784,789,790,2759,2760,23930,23931,25140,26103,27924,27925,52382,54064,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28636859$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Dudzinski, David M</contributor><contributor>Cabot, Richard C</contributor><contributor>Rosenberg, Eric S</contributor><contributor>Shepard, Jo-Anne O</contributor><contributor>Harris, Nancy Lee</contributor><contributor>Pierce, Virginia M</contributor><contributor>Baggett, Meridale V</contributor><contributor>McDonald, Emily K</contributor><contributor>Ebeling, Sally H</contributor><contributor>Sgroi, Dennis C</contributor><contributor>Shepard, Jo-Anne O.</contributor><contributor>Ebeling, Sally H.</contributor><contributor>Dudzinski, David M.</contributor><contributor>Pierce, Virginia M.</contributor><contributor>Baggett, Meridale V.</contributor><contributor>Sgroi, Dennis C.</contributor><contributor>Rosenberg, Eric S.</contributor><contributor>McDonald, Emily K.</contributor><contributor>Cabot, Richard C.</contributor><creatorcontrib>David, William S</creatorcontrib><creatorcontrib>Bowley, Michael P</creatorcontrib><creatorcontrib>Mehan, William A</creatorcontrib><creatorcontrib>Shin, John H</creatorcontrib><creatorcontrib>Gerstner, Elizabeth R</creatorcontrib><creatorcontrib>DeWitt, John C</creatorcontrib><title>Case 19-2017 — A 53-Year-Old Woman with Leg Numbness and Weakness</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>A 53-year-old woman was admitted to the hospital because of progressive asymmetric hypoesthesia and weakness in the legs. Urinary retention, absence of rectal tone, and saddle anesthesia developed. A diagnostic test was performed.
Presentation of Case
Dr. Kristyn M. Spera
(Neurology): A 53-year-old woman with rheumatoid arthritis was admitted to this hospital because of progressive asymmetric hypoesthesia and weakness in the legs.
The patient had been in her usual health until 4 months before this admission, when hypoesthesia developed in the lateral aspect of the left foot. During the following 2 days, the hypoesthesia spread to involve the toes and midfoot. On evaluation by her primary care physician, the patient reported that her chronic low-back pain, which radiated to the buttocks, had increased in intensity, but there was no pain in the legs, . . .</description><subject>Anesthesia</subject><subject>Bladder</subject><subject>Brain - diagnostic imaging</subject><subject>Brain - pathology</subject><subject>Cancer</subject><subject>Case reports</subject><subject>Cerebrospinal Fluid - chemistry</subject><subject>Cerebrospinal Fluid - cytology</subject><subject>Diagnosis, Differential</subject><subject>Electromyography</subject><subject>Female</subject><subject>Humans</subject><subject>Hypesthesia - etiology</subject><subject>Leg</subject><subject>Legs</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Lymphoma</subject><subject>Lymphoma, Large B-Cell, Diffuse - complications</subject><subject>Lymphoma, Large B-Cell, Diffuse - diagnostic imaging</subject><subject>Lymphoma, Large B-Cell, Diffuse - pathology</subject><subject>Magnetic Resonance Imaging</subject><subject>Medical diagnosis</subject><subject>Middle Aged</subject><subject>Muscle Weakness - etiology</subject><subject>Nervous system</subject><subject>Neurology</subject><subject>Neurosurgery</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Pain</subject><subject>Peripheral Nervous System - anatomy & histology</subject><subject>Peripheral Nervous System - physiology</subject><subject>Rectum</subject><subject>Rheumatoid arthritis</subject><subject>Sarcoidosis - diagnosis</subject><subject>Spinal Nerve Roots - pathology</subject><subject>Stem cells</subject><subject>Tuberculosis - diagnosis</subject><subject>Womens health</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp10E1LwzAcBvAgipvTq0cJCOIlMy9t2hxHmW_M7aKIp5Im_-rm0s5mRbz5IfyEfhIzNgUFc0gI-eVJeBA6ZLTPaCzPxsPrG7MwLKEskXwLdVksBIkiKrdRl1KekihRooP2vJ_RMFikdlGHp1LINFZdlGXaA2aK8BCAP98_8ADHgjyAbshkbvF97XSFX6fLJzyCRzxuXVGB91hX4Qz082qzj3ZKPfdwsFl76O58eJtdktHk4iobjIgRcbQkwspSS2MgKrhJWalKw4RVMi2KWFnObcGo4KC1ASOh0EokSSBRCtYymyaih07XuYumfmnBL3M39Qbmc11B3fqcKcYlTcMU6PEfOqvbpgq_C0qwJLwqVFD9tTJN7X0DZb5opk43bzmj-are_He94cLRJrYtHNgf_t1nACdr4JzPK5i5_5K-AImcfwU</recordid><startdate>20170622</startdate><enddate>20170622</enddate><creator>David, William S</creator><creator>Bowley, Michael P</creator><creator>Mehan, William A</creator><creator>Shin, John H</creator><creator>Gerstner, Elizabeth R</creator><creator>DeWitt, John C</creator><general>Massachusetts Medical Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20170622</creationdate><title>Case 19-2017 — A 53-Year-Old Woman with Leg Numbness and Weakness</title><author>David, William S ; Bowley, Michael P ; Mehan, William A ; Shin, John H ; Gerstner, Elizabeth R ; DeWitt, John C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-3d6fa6cce4b2c81f9fc13d968bb59d22db1032eaacec6eba9377fc148edd1d873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Anesthesia</topic><topic>Bladder</topic><topic>Brain - diagnostic imaging</topic><topic>Brain - pathology</topic><topic>Cancer</topic><topic>Case reports</topic><topic>Cerebrospinal Fluid - chemistry</topic><topic>Cerebrospinal Fluid - cytology</topic><topic>Diagnosis, Differential</topic><topic>Electromyography</topic><topic>Female</topic><topic>Humans</topic><topic>Hypesthesia - etiology</topic><topic>Leg</topic><topic>Legs</topic><topic>Lumbar Vertebrae - diagnostic imaging</topic><topic>Lymphoma</topic><topic>Lymphoma, Large B-Cell, Diffuse - complications</topic><topic>Lymphoma, Large B-Cell, Diffuse - diagnostic imaging</topic><topic>Lymphoma, Large B-Cell, Diffuse - pathology</topic><topic>Magnetic Resonance Imaging</topic><topic>Medical diagnosis</topic><topic>Middle Aged</topic><topic>Muscle Weakness - etiology</topic><topic>Nervous system</topic><topic>Neurology</topic><topic>Neurosurgery</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Pain</topic><topic>Peripheral Nervous System - anatomy & histology</topic><topic>Peripheral Nervous System - physiology</topic><topic>Rectum</topic><topic>Rheumatoid arthritis</topic><topic>Sarcoidosis - diagnosis</topic><topic>Spinal Nerve Roots - pathology</topic><topic>Stem cells</topic><topic>Tuberculosis - diagnosis</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>David, William S</creatorcontrib><creatorcontrib>Bowley, Michael P</creatorcontrib><creatorcontrib>Mehan, William A</creatorcontrib><creatorcontrib>Shin, John H</creatorcontrib><creatorcontrib>Gerstner, Elizabeth R</creatorcontrib><creatorcontrib>DeWitt, John C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>David, William S</au><au>Bowley, Michael P</au><au>Mehan, William A</au><au>Shin, John H</au><au>Gerstner, Elizabeth R</au><au>DeWitt, John C</au><au>Dudzinski, David M</au><au>Cabot, Richard C</au><au>Rosenberg, Eric S</au><au>Shepard, Jo-Anne O</au><au>Harris, Nancy Lee</au><au>Pierce, Virginia M</au><au>Baggett, Meridale V</au><au>McDonald, Emily K</au><au>Ebeling, Sally H</au><au>Sgroi, Dennis C</au><au>Shepard, Jo-Anne O.</au><au>Ebeling, Sally H.</au><au>Dudzinski, David M.</au><au>Pierce, Virginia M.</au><au>Baggett, Meridale V.</au><au>Sgroi, Dennis C.</au><au>Rosenberg, Eric S.</au><au>McDonald, Emily K.</au><au>Cabot, Richard C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Case 19-2017 — A 53-Year-Old Woman with Leg Numbness and Weakness</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>2017-06-22</date><risdate>2017</risdate><volume>376</volume><issue>25</issue><spage>2471</spage><epage>2481</epage><pages>2471-2481</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract>A 53-year-old woman was admitted to the hospital because of progressive asymmetric hypoesthesia and weakness in the legs. Urinary retention, absence of rectal tone, and saddle anesthesia developed. A diagnostic test was performed.
Presentation of Case
Dr. Kristyn M. Spera
(Neurology): A 53-year-old woman with rheumatoid arthritis was admitted to this hospital because of progressive asymmetric hypoesthesia and weakness in the legs.
The patient had been in her usual health until 4 months before this admission, when hypoesthesia developed in the lateral aspect of the left foot. During the following 2 days, the hypoesthesia spread to involve the toes and midfoot. On evaluation by her primary care physician, the patient reported that her chronic low-back pain, which radiated to the buttocks, had increased in intensity, but there was no pain in the legs, . . .</abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>28636859</pmid><doi>10.1056/NEJMcpc1701762</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | The New England journal of medicine, 2017-06, Vol.376 (25), p.2471-2481 |
| issn | 0028-4793 1533-4406 |
| language | eng |
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| source | MEDLINE; New England Journal of Medicine Current; EZB-FREE-00999 freely available EZB journals; ProQuest Central UK/Ireland |
| subjects | Anesthesia Bladder Brain - diagnostic imaging Brain - pathology Cancer Case reports Cerebrospinal Fluid - chemistry Cerebrospinal Fluid - cytology Diagnosis, Differential Electromyography Female Humans Hypesthesia - etiology Leg Legs Lumbar Vertebrae - diagnostic imaging Lymphoma Lymphoma, Large B-Cell, Diffuse - complications Lymphoma, Large B-Cell, Diffuse - diagnostic imaging Lymphoma, Large B-Cell, Diffuse - pathology Magnetic Resonance Imaging Medical diagnosis Middle Aged Muscle Weakness - etiology Nervous system Neurology Neurosurgery NMR Nuclear magnetic resonance Pain Peripheral Nervous System - anatomy & histology Peripheral Nervous System - physiology Rectum Rheumatoid arthritis Sarcoidosis - diagnosis Spinal Nerve Roots - pathology Stem cells Tuberculosis - diagnosis Womens health |
| title | Case 19-2017 — A 53-Year-Old Woman with Leg Numbness and Weakness |
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