Case Presentation: 59 year old female presented to the emergency department complaining of two weeks of atraumatic, painful bruising to her lower extremities, right shoulder, and lower back. She was unable to bear weight on her right lower extremity due to pain.  She denied any history of anticoagulant or antiplatelet usage, and denied any family [...]

Case Presentation: A 76-year-old woman with history of non-small cell lung cancer status post chemoradiation five years ago presented with acute onset of diffuse muscle weakness and swelling in bilateral forearms and legs, with a “woody” texture on palpation but without fluctuance. BP and HR were normal, but she had recurrent fevers as high as [...]

Case Presentation: An 87 year old male with a history HFrEF 35%, BPH, Afib, seizure disorder. He had a recent fall and presented with A-fib with RVR. His creatinine at that time was found to be 5.6 (no baseline creatinine at that time). Renal and bladder ultrasound showed large intravesical mass consistent with bladder mass [...]

Case Presentation: An 80-year-old female with a history significant for breast cancer status post mastectomy with chemo/radiation therapy and phenytoin-induced liver injury in 2013 presented with nine months of weakness, weight loss, and 2-3 month history of confusion, memory loss, and widespread tremors, suspicious for focal status epilepticus. Workup revealed hyponatremia (135 mmol/L) and elevated [...]

Case Presentation: A 74-year-old Hispanic male patient with a history of monoclonal gammopathy of undetermined significance presented with worsening right upper extremity (RUE) motor weakness for the last few months. This was present in an ulnar nerve distribution with muscle wasting in the hypothenar and fourth and fifth metacarpal areas. Blood work was notable for [...]

Case Presentation: A 63-year-old man with a history of hypertension presented with gait instability, progressive over one month, as well as positional hand tremors and nausea. On initial evaluation, he was afebrile with blood pressure of 169/98. Abnormalities on neurological examination included ocular flutter, left upper extremity dysmetria and wide-based cautious gait with bilateral leg [...]

Case Presentation: A 60-year-old female with metastatic breast cancer presented with involuntary irregular forceful and painful contractions of facial muscles and dystonic posturing of her hands and feet lasting 5 to 30 minutes. Episodes sporadically occurred up to 20 times daily. MRI brain and spinal cord showed no evidence of metastatic disease or dural enhancement. [...]

Case Presentation: A 76-year-old male with a history of allergic rhinitis presented to the hospital with four weeks of persistent dry cough. His cough is exacerbated by mild exertional activities and occurs at all hours. He had no nasal congestion, sore throat, hoarseness, hemoptysis, dyspnea, dysphagia, heartburn, or recent respiratory tract infection. He reported no [...]

Case Presentation: A 51-year-old female presented with a three month history of migratory rash and weakness. Initially, she developed periorbital swelling, eyelid discoloration, and a migrating pruritic erythematous rash. The rash originated on her upper arms and thighs progressing to her chest, back, and face. She reported muscle weakness, most notably an inability to lift [...]

Case Presentation: A 69 year old man with history of Stage IV Mantle cell lymphoma on maintenance Rituximab presented to the emergency department with acute confusion and expressive aphasia. Patient was at his behavioral and functional baseline prior to this episode and there had not been any recent illnesses, medication changes or inciting events. Initial [...]