Background: The growth of oral muscle relaxant prescriptions among older adults in the U.S. raises safety concern. Baclofen is a commonly used gamma-aminobutyric acid (GABA) agonist muscle relaxant that is associated with encephalopathy. We aimed to compare the risk of fall and fracture associated with oral baclofen against other muscle relaxants (tizanidine or cyclobenzaprine) in [...]

Case Presentation: A 73-year-old woman with a past medical history of hypertension and osteoarthritis presented to the emergency department with progressive right lower back pain after a mechanical fall, subacute oropharyngeal dysphagia, and diffuse proximal and distal muscle weakness. On presentation, she was afebrile with unremarkable vital signs. Her labs were significant for a WBC [...]

Case Presentation: A 68-year-old woman with a history of hypertension and possible interstitial lung disease presented with one week of worsening midsternal chest pain, diaphoresis and nausea. Initial vitals were unremarkable. Exam revealed bibasilar crackles but no murmur, gallop, elevated jugular venous pressure or abdominal tenderness. An electrocardiogram showed no acute ischemic changes. Initial troponin [...]

Case Presentation: A 79-year-old woman with hypertension and hyperlipidemia arrived to the ER after a syncopal episode. She was found in intermittent polymorphic ventricular tachycardia (VT). She was treated medically, briefly regaining sinus rhythm with possible ischemic changes (Figure 1). She was transferred to a cardiac catheterization capable facility. The study showed proximal left anterior [...]

Case Presentation: A 69-year-old male with a past medical history of hyperlipidemia on atorvastatin and type 2 diabetes presenting with progressive muscle pain and weakness. Who reports proximal muscle weakness, worsening over four years, and most prominent in the lower extremities. He started atorvastatin approximately one year prior to evaluation and has a family history [...]

Case Presentation: Introduction: Hypokalemic periodic paralysis (HOKPP) is characterized by transient episodes of muscle weakness and inability of muscle movement associated with hypokalemia. The paralysis typically affects the arms and legs, though the diaphragm and the tongue may also be affected.Case Description: A 50-year-old female with tobacco use and significant alcohol consumption presented with progressive [...]

Case Presentation: A 51-year-old African-American female was admitted to the hospital with 3 days of bilateral calf pain, described as a severe cramping pain that started in the left medial calf. The patient first noticed the pain after walking two blocks. The pain did not subside with rest. The next day, the patient noticed similar [...]

Case Presentation: We describe an interesting case of a 59-year-old female patient who arrived unresponsive to ED, with symptoms concerning for acute coronary syndrome(ACS). There was no informant present along with the patient, so very limited information was available about patient’s past medical history or risk factors. EMS personnel who accompanied the patient reported that [...]

Case Presentation: Lyme disease (LD) is caused by the Ixodes tick-borne infection with spirochetes Borrelia burgdorferi [1]. LD is most commonly reported in the Northeastern and upper Midwestern United States [2]. It is divided into three stages. Early localized, stage 1, with Erythema Migrans (EM) bull’s eye lesion present in 70-80% of patients [1], within [...]

Case Presentation: Statin-induced necrotizing autoimmune myopathy (SINAM) is an immune mediated myopathy characterized by proximal muscle weakness and necrosis in the presence of autoantibodies to hydroxyl-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase. It is a rare side effect of statin use that must be recognized quickly in order to prevent the development of irreversible muscle weakness. Most cases occur [...]