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Acute Unilateral Numbness And Weakness In A Professional Basketball Player - Page #1
 

Author: Rabiah Fresco, MD
Senior Editor: Drew Duerson, MD
Editor: Jason Friedman, MD

Patient Presentation:
A 25-year-old male professional basketball player presented to the emergency department (ED) complaining of acute onset numbness and weakness of his right upper and lower extremities after a spin move. Associated symptoms included pain, paresthesias, and cold sensation.

History:
He was initially evaluated by his team physician, who sent the patient to urgent care. An ECG performed at urgent care was concerning for possible myocardial infarction and the patient was referred to the ED. On arrival, he denied chest pain, dizziness, palpitations, or syncope. He did report a history of a recent dental procedure (wisdom tooth removal) one week prior, as well as a recent plane flight.

Physical Exam:
General: no acute distress
Cardiovascular: regular rate and rhythm, no murmur
Respiratory: clear to auscultation bilaterally
Neuro Exam:
Mental status: awake, alert, oriented x 3; no aphasia, no dysarthria
Cranial Nerves: cranial nerves II-XII intact
Motor: normal tone, no significant atrophy. Strength 4/5 in right upper and lower extremities, 5/5 in left upper and lower extremities
Sensory: decreased sensation to light touch in the right arm and leg; sensation intact in the right foot
Reflexes: mild hyporeflexia, 1+ symmetrically. Babinski downgoing bilaterally
Coordination: finger-to-nose and heel-to-shin intact bilaterally
Gait: ambulated steadily but reported feelings of weakness in the right leg

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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