Avatar universal

Diagnoses for gross weakness post c/s arthroplasty?

History: Mid-30s female: C6/7 arthroplasty ~6 mos ago to address L>R UE heaviness > weakness, slight LE weakness, R saddle region numbness.  Positive hoffman's, clonus, weakness (triceps>biceps, L wrist extension, L opposition), and hyperreflexive triceps and patellar DTR. Transient L hypothenar numbness, left lateral brachial burning sensation.

Post-op: immediate and significant increase in: all UE and LE weakness (proximal>distal), plus new: decreased sensation L>R LE distal >proximal, transient nerve burn (B lateral brachial, L>R posterior leg and plantar foot), cognitive deficits (executive function, concentration, short-term memory, word finding, multi-tasking), gait changes (crouched, adducted, loss of balance, LE buckling with transfers and stairs), gross saddle region tingling and decreased sensation, delayed ankle balance strategies, fine motor coordination deficits, and extreme fatigue.

Positive exam findings: DTR all UE and LE hyperreflexive B, clonus, hoffman's, weakness ( triceps, biceps, wrist and finger extension, opposition, finger abduction, ankle DF, ankle PF, hamstring, hip flexion, knee extension, 1st toe extension)

Negative workups (MRI -brain, t-spine, c-spine, lumbar, LP labs, dynamic c-spine repeat xrays, c-spine myelogram, blood work, SSERs UE & LE, rheum panels, LE EMG NCV). Slight resolving C8 radiculopathy on EMG L.

Docs are stumped- rec'd seeking out tertiary care center such as Hopkins. Any thoughts on diagnoses, ideas to try, people to see?

0 Responses
Sort by: Helpful Oldest Newest
Have an Answer?

You are reading content posted in the Neurology Community

Top Neurology Answerers
620923 tn?1452915648
Allentown, PA
5265383 tn?1669040108
1756321 tn?1547095325
Queensland, Australia
1780921 tn?1499301793
Queen Creek, AZ
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Find out how beta-blocker eye drops show promising results for acute migraine relief.
In this special Missouri Medicine report, doctors examine advances in diagnosis and treatment of this devastating and costly neurodegenerative disease.
Here are 12 simple – and fun! – ways to boost your brainpower.
Discover some of the causes of dizziness and how to treat it.
Discover the common causes of headaches and how to treat headache pain.
Two of the largest studies on Alzheimer’s have yielded new clues about the disease