A Rare Case of Paralysis

​BY ALEXANDRA SALAS; JENNIFER TUONG; IVAN KHARCHENKO; VICTOR RIVERA; & AHMED RAZIUDDIN, MDA 27-year-old man with a past medical history of ADHD managed with Adderall presented to the emergency department with bilateral upper leg weakness associated with soreness since the day before. He had run 2.5 miles before his symptoms started.The symptoms progressively worsened until he was not able to walk or get up from a sitting position. He was also experiencing weakness in his arms. He had no associated trauma, headache, vision changes, chest pain, shortness of breath, fever, abdominal pain, nausea, vomiting, diarrhea, or genitourinary symptoms. He appeared well developed and well nourished, had normal speech without slurring, and was in no acute distress. His skin was pale, warm, and sweaty to the touch. He was alert, cooperative, and oriented to person, place, and time.He was tachycardic with audible S1 and S2. The musculoskeletal exam was significant for thigh muscle strength of 4/5 bilaterally and lower leg muscle strength of 5/5 bilaterally.The patient's vital signs were a blood pressure of 155/94 mm Hg, a heart rate of 105 bpm, a respiratory rate of 22 bpm, a temperature of 97.9°F, and a pulse oximetry of 97% on room air. Abnormal laboratory results were a low potassium of 2.3 mEq/L, an elevated creatine kinase of 1549 U/L, and elevated ALT of 58 U/L and AST of 59 U/L. ECG findings were normal other than a prolonged QT interval of 592 ms and a QTc of 736 ms, which coul...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research