Don't Tell Me It's All In My Head

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Don't Tell Me It's All In My Head - Page #1

Author: Bryce Meredith, DO Co Author #1: David Rupp, MD Co Author #2: Lauren Curley, MS, ATC Co Author #3: C. Andrew Gilliland, MD Senior Editor: Charlie Michaudet, MD Editor: Margaret Gibson, MD, FAMSSM Patient Presentation: Patient is a 20 year old female college basketball player who was evaluated in the training room for recurrent episodes that initially started as hand tingling. History: Patient is a 20 year old female college basketball player who was evaluated in the training room for recurrent episodes that initially started as hand tingling. She reported she had transient episodes of hand tingling in high school while playing basketball, but these episodes would resolve spontaneously. However, during her sophomore year in college, these episodes of hand tingling started again with physical activity. At that time, she also started having facial, lip and hand swelling. She was also experiencing heaviness in her face and upper extremities. She would have a tremor in both upper extremities as well. These episodes continued to resolve after about 10 minutes with rest. After each of these episodes she would have a headache and feel fatigued. She denied any rash or hives. She denied any abdominal pain, nausea, vomiting, diarrhea, or constipation. Physical Exam: Constitutional: She appeared well-developed and well-nourished. Head: Normocephalic and atraumatic. Eyes: Conjunctivae and EOM were normal. Pupils were equal, round, and reactive to light. Neck: Normal range of motion. Neck supple. Cardiovascular: Normal rate and regular rhythm. No murmur Pulmonary/Chest: Normal Respiratory effort. Breath sounds normal. Neuro: Awake, alert, and Oriented x 3. Cranial Nerves II-XII intact. Strength: 5/5 upper and lower extremities. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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