Case Presentation: A 25 year-old male with no significant past medical history presented to the emergency department after he woke up with sudden onset weakness in his bilateral thighs and arms. He had history of heat intolerance, palpitations, dysphagia and weight loss of 40 pounds over last 3 months but denied any changes in skin, [...]

Case Presentation: A 63 year-old man with diabetes mellitus, hypertension, and GERD presented from an outside hospital with bilateral upper extremity paralysis, paresthesias, and neck pain which started minutes after sneezing. Vital signs were stable and neurologic examination was remarkable for bilateral upper extremity strength of 0/5 with absent reflexes and reduced sensation to pinprick. [...]

Case Presentation: A 46 year old man living in southwestern Maine with a history of hypertension, hyperlipidemia, and obesity presented in late September with 2 days of numbness in the right foot that progressed to bilateral lower extremity weakness, numbness, and difficulty ambulating. Patient denied any recent illnesses, vaccinations, travel or known bites the month [...]

Case Presentation: A twenty-year-old male patient with no past medical history presented to the emergency department with bilateral lower extremity weakness after working in agricultural fields which had progressed over three hours to near paralysis. When the patient was first evaluated, an ECG revealed his heart rhythm to be in asymptomatic ventricular tachycardia. He exhibited [...]

Case Presentation: An 18-year-old male presented with ascending paralysis, starting in the lower extremities and progressing to the upper extremities over 24 hours after a carbohydrate rich meal. Other review of systems was negative. He reported one prior ICU admission for similar symptoms, but details were not available. Father and grandfather had similar presentations of [...]

Case Presentation: A 3-year-old female who recently returned from a bear-hunting trip in Idaho presented with a 4-day history of progressive ascending paralysis and hyporeflexia. Her symptoms initially started 4 days prior to presentation with difficulty walking and progressed to difficulty urinating and eventual upper extremity weakness. The family did not seek medical care until [...]

Case Presentation: A four-year-old previously healthy, vaccinated female presented with severe, acute-onset ataxia. She was in her usual state of health until the day prior to presentation, when she was picked up from school and reported feeling like she was going to fall. She continued to develop progressive unsteadiness and experienced several falls throughout the [...]

Case Presentation: A 54-year-old woman with no significant PMH presented with a macular rash, truncal pain, and progressive bilateral lower extremity weakness. She denied recent illness or travel, but did report frequent mosquito bites, as well as multiple recent sexual partners. She had no outdoor exposure except regular strolls on the Beltline, a popular urban [...]

Case Presentation: A 51-year-old female with a history of lumbar stenosis (status post-transforaminal epidural steroid injection), hypertension, and migraines presented with altered mental status and severe acute headache. The day before, she experienced unusual lower back pain and, after consuming shrimp scampi, developed abdominal pain, nausea, flaccidity in her upper extremities, dysarthria, and a severe [...]

Case Presentation: Severe peripheral disease with arterial thrombosis can present as bilateral leg paralysis and extreme pain. Caution must be exercised to exclude vascular pathology ( in addition to neurologic differentials), to avoid premature closure of diagnosis and to avoid catastrophic outcomes. One such rare disorder is Leriche syndrome, whereby, patients develop aortoiliac thrombotic occlusion, [...]