BrainWaves #24 Teaching through clinical cases: Progressive paresthesias and ataxia in a young patient

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.

Originally released: July 18, 2017

In this week's episode of Teaching through Clinical Cases, Dr. Michael Rubenstein (episode #17, "The FAME clinic in Tanzania") leads a discussion on the evaluation of a young patient with a rapidly progressive gait difficulty with numbness and paresthesias. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision-making in routine clinical practice. Any cases discussed in this episode are fictional and do not contain any patient health-identifying information. This episode was vetted and approved by Michael Rubenstein.

REFERENCES

Goodman BP. Metabolic and toxic causes of myelopathy. Continuum (Minneap Minn) 2015;21(1 Spinal Cord Disorders):84-99. PMID 25651219

Kriegstein AR, Shungu DC, Millar WS, et al. Leukoencephalopathy and raised brain lactate from heroin vapor inhalation ("chasing the dragon"). Neurology 1999;53(8):1765-73. PMID 10563626

Kumar N, Elliott MA, Hoyer JD, Harper CM Jr, Ahlskog JE, Phyliky RL. "Myelodysplasia," myeloneuropathy, and copper deficiency. Mayo Clin Proc 2005;80(7):943-6. PMID 16007901

Pema PJ, Horak HA, Wyatt RH. Myelopathy caused by nitrous oxide toxicity. AJNR Am J Neuroradiol 1998;19(5):894-6. PMID 9613506

Stabler SP. Vitamin B12 deficiency. N Engl J Med 2013;368(21):2041-2. PMID 23697526

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