emad
14-01-2006, 07:13 PM
Hi all ;
Today i encounter a patient needs long clinical reasoning process to detect where is the nervous system defect .
39 years lady ,has severe burning pain and numbness below the left knee, her main complaint i can not control my foot in walking , i can not sleep ,i have extremely cold leg , i can not bear this coldness , i put on 2 plankets over my lleg , but still feel very cold .
Past history :
# Operated as lumbar disc in 1996 and in 1998
# I had an attack like this current attack since 3 years in the same left
side .
My evaluation revealed :
MOTOR
# SLRT ++++, reffers only to the calf muscle .
# Dorsi , grade 3+
#evers , grade 0
# Inver ,grade 0
# Knee exte , grade 5
# knew flex ,grade 5
# Toes planter ,grade 4
# Toes dorsi , grade 3-
Sensory :
Affected at foot plater aspect and lateral lower leg third aspect.
Lumbar plapation reavealed no pain at all ,however ,she says there is very slight pain at gluteus .
Physiological Motions :
NO pain.
Hip joint free .
Where is the nervous system injury ??
Why all this cold feel ?
What are your magement tools ?
Personally , i began with assurance because she is very worry ,breathing ex , neurdynamics of both lower limbs , eduacte her regarding postions which put more stress /load over the nervous system .
Regards
Emad
Today i encounter a patient needs long clinical reasoning process to detect where is the nervous system defect .
39 years lady ,has severe burning pain and numbness below the left knee, her main complaint i can not control my foot in walking , i can not sleep ,i have extremely cold leg , i can not bear this coldness , i put on 2 plankets over my lleg , but still feel very cold .
Past history :
# Operated as lumbar disc in 1996 and in 1998
# I had an attack like this current attack since 3 years in the same left
side .
My evaluation revealed :
MOTOR
# SLRT ++++, reffers only to the calf muscle .
# Dorsi , grade 3+
#evers , grade 0
# Inver ,grade 0
# Knee exte , grade 5
# knew flex ,grade 5
# Toes planter ,grade 4
# Toes dorsi , grade 3-
Sensory :
Affected at foot plater aspect and lateral lower leg third aspect.
Lumbar plapation reavealed no pain at all ,however ,she says there is very slight pain at gluteus .
Physiological Motions :
NO pain.
Hip joint free .
Where is the nervous system injury ??
Why all this cold feel ?
What are your magement tools ?
Personally , i began with assurance because she is very worry ,breathing ex , neurdynamics of both lower limbs , eduacte her regarding postions which put more stress /load over the nervous system .
Regards
Emad