Case Presentation: A 32 year old male presented to the emergency department unresponsive. Three months prior he had developed urinary incontinence, cognitive impairments, paresthesias in his extremities and weakness requiring crutches. His symptoms progressed leaving him bed bound weeks prior to arrival. EMS was contacted when he became unresponsive to verbal-noxious stimuli and exhibited difficulty […]

Case Presentation: A 40 year-old female presented to the Emergency Department with several months of fatigue followed by acute fever and confusion. She denied weight loss, swollen glands, cough, rash, arthralgias, or myalgias. No drug or alcohol use. She was febrile to 102.5F. The remainder of the vital signs were normal, and the neuro exam […]

Case Presentation: A 39-year-old male with no past medical history presented with four days of a constant “pins and needles” sensation located from fingertips through elbows bilaterally as well as progressive shortness of breath and fatigue. He reported feeling unbalanced and light-headed. Additionally, for seven months he experienced confusion including word finding difficulties. Further history […]

Case Presentation: A 49-year-old vegetarian male (on supplements with vitamin B12) with recent myocardial infarction (MI) presented with 8-months of worsening neurological symptoms beginning as paresthesias progressing to cognitive decline and gait instability. Physical exam was significant for poor recall, inability to perform basic calculations, impaired proprioception in the right lower extremity, sensory ataxia in […]