CASE : A 23 YR OLD MALE WITH PARAPARESIS.

Case : A 23 yr old autodriver with complaints of paraparesis.

I've been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan. 

You can find the entire real patient clinical problem in this link here..

https://vaish7.blogspot.com/2020/05/medicine.html?m=1

CHIEF COMPLAINTS :

1. Weakness of bilateral lower limbs since 5 days associated with tingling and numbness. 

2. Vomitings since 5 days non-projectile, non-bilious,food particles is content. 

3. Sudden fall when got up for urination. 

4. Gluteal abscess since 5 months. 

5. Scrotal abscess since 20 days. 

LOCATION OF THE CAUSE :

- Cause of paraparesis lies in anterior           right  and left cerebral hemispheres and   pyramidal tracts. 

ETIOPATHOLOGY OF THE CAUSE :

- On MRI examination : 

   . Disseminated tuberculosis as there is         ring enhancing lesions in brain. 

   . So in this patient, the bacteria may               spread from lumbosacral abscess to           blood and it may reach the brain via             circle of Willis and cause paraparesis. 

PROBABLE DIAGNOSIS :

Paraparesis with L4,L5infective spondylodiscitis with left psoas abscess with ring enhancing lesions in right and left cerebral hemispheres with healing ulcer in right gluteal region secondary to drained gluteal abscess with pyocele left side operated ( 10 days back). 

TREATMENT :

1)T.ATT 3 tabs/day fdc

2)T.Benadon 40mg/od

3)T.pregabalin 75mg/po/h/s.