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• W2898052182 abstract "A gentleman in his late 40s developed a “pins and needles” sensation and numbness in his left hand that was exacerbated by leaning on his left arm or hyperextending his neck. The numbness developed over a few weeks. Over the next 2 months, the numbness spread proximally in the left arm, then to the right arm, and in patches over his bilateral upper chest and next to the bilateral posterior thighs. He denied pain, weakness, fatigue, cognitive changes, vision changes, dysarthria, or dysphagia or changes in bladder or bowel function. A review of systems was otherwise negative or normal. Past medical history was notable for hyperlipidemia, treated with atorvastatin 20 mg daily. There was no family history of neurologic or autoimmune disease. Vital signs and general physical examination were normal. Neurologic examination was notable for normal mental status and cranial nerve examinations. Gait, coordination, and the remainder of the motor examinations were normal. Sensation was mildly reduced to light touch circumferentially throughout both arms, in patches over the anterior chest, and over the posterior thighs, with preserved sensation to vibration, pinprick, and temperature. The Romberg sign was not present. Deep tendon reflexes were normal. The plantar response was flexor bilaterally.The authors wish to express their gratitude to their medical illustrator, Mr. Jason Ooi, for his evidence-based rendition of the putative mechanisms underlying noncaseating granulomatous inflammation in neurosarcoidosis. The authors also wish to acknowledge the UCSF MS EPIC Study Team. The National Multiple Sclerosis Society Case Conference Proceedings is a peer review publishing initiative from the monthly; Diagnostic and Treatment Challenges in MS and Neuroimmunology Webinars; sponsored by the National Multiple Sclerosis Society Fellowship Training Program; and Directed by Elliot M Frohman, MD, PhD." @default.
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• W2898052182 date "2018-10-23" @default.
• W2898052182 modified "2023-09-26" @default.
• W2898052182 title "A young man with numbness in arms and legs" @default.
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• W2898052182 doi "https://doi.org/10.1212/nxi.0000000000000509" @default.
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