Case 12: A 56-Year-Old Man With Acute Quadriparesis


April 26, 2002

Case Presentation

The patient is a 56-year-old black man with a history of hypertension, hiatal hernia, and occasional cocaine use who presented to the emergency department (ED) with acute onset of dizziness, chest pain, and quadriparesis. He was in his usual state of good health until the morning of admission when he experienced an acute onset of chest discomfort with dizziness and had to sit down in a chair. Shortly afterward, he felt tingling in all extremities, became diaphoretic, and could not move his limbs. He denied involvement of his face, vertigo, or diplopia. His speech was clear.

He was brought by ambulance to the ED where he developed difficulty breathing; a neurology consult was obtained.

The patient denied any trauma or neck injury, coronary artery disease, diabetes, alcohol, recent illness, travels, fever or chill, headache, gastrointestinal, or urinary symptoms. He reported no recent weight loss or night sweats.


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