A 60 yr old male presented with chief complaints of both low
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Ajay Jain Jain
A 60 yr old male presented with chief complaints of both lower limb weakness since last 15 days which was insidious in onset, progressive and symmetrical. He is able to sit from supine but not able to stand on his own. During this course early he used 1 stick to walk but now needs support on both sides. No history of any numbness nor loss of any sensation. He is also not able to wear his slippers. No history of any urinary incontinence, diurnal variation, abnormal movements, swaying, fever, headache, neck stiffness.Normal bowl and bladder habits. He had past history of falling laterally while sleeping on his bed on right side and accompanied by right side mild pelvic area pain only with no effect on his daily activity. On examination his higher functions are intact with normal cranial nerve examination. Motor examination reveals no muscle atrophy, normal tone, power decreased in knee flexion and toes dosriflexion to grade 3 and hip flexion and abduction to grade 2. Plantar extensors present on both toes. Deep tendon reflexes are exaggerated in lower limbs with normal on upper limbs. No sensory and perception loss.No tenderness on spine at any level.
MRI reports compression at multiple levels of spine with prominent at L3 level.
What should be the next step?.
Dr. R●●●●●●a N●●h and 3 others like this
Like
Comment
Share