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Clinical Reasoning: A 60-Year-Old Man With Asymmetric Weakness and Persistent Fever. | LitMetric

Clinical Reasoning: A 60-Year-Old Man With Asymmetric Weakness and Persistent Fever.

Neurology

From the Departments of Neurology (Y.Z.), Zhejiang Provincial Hospital of Chinese Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou; Departments of Pathology (J.-J.X.), Rheumatology (X.-F.Z., J.H.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Department of Pharmacy (S.Z.), The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou; and Department of Neurology (M.-P.D.), Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

Published: March 2023

AI Article Synopsis

Article Abstract

Peripheral neuropathies, especially those with atypical features, remain a diagnostic challenge. In this case, a 60-year-old patient presented with acute-onset weakness starting in the right hand then sequentially involving the left leg, left hand, and right leg over 5 days. The asymmetric weakness was accompanied by persistent fever and elevated inflammatory markers. Subsequent development of rashes combined with careful review of the history led us to the final diagnosis and targeted treatment. This case highlights clinical pattern recognition with the help of electrophysiologic studies in peripheral neuropathies, which provide shortcuts to narrow the differential diagnosis. We also illustrate the important pitfalls from history taking to ancillary testing in diagnosing the rare but treatable cause of peripheral neuropathy (eFigure 1, links.lww.com/WNL/C541).

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10074466PMC
http://dx.doi.org/10.1212/WNL.0000000000201697DOI Listing

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