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UNABLE TO STAND
Nutritional deficiency (vit B12)
Other (rare metabolic, genetic)
Toxins (drugs, toluene, mercury)
Demyelination (Miller Fisher, Guillain Barre, MS)
Altered Mental Status
I WATCH DEATH
Cerebellar vs. sensory ataxia
See more dysdiadochokinesia and dysmetria with cerebellar. Also hypotonia. Unilateral suggests a focal lesion, bilateral is more likely due to diffuse causes
(drug, alcohol, paraneoplastic)
See more sensory, proprioceptive, and vibratory deficits with sensory.
(Vit B12 def, tabes dorsalis)
Trauma (post concussive)
Toxins (drugs, toluene, alcohol)
Metabolic diseases presenting with recurrent or progressive ataxias
maple syrup urine disease,
I CONVULSE BIG TIME
Lytes (hypoNa, hypoMg, hypoCa)
Inborn error of metabolism
Things to include in the history-taking of a seizure
focal motor activity during the sz
was the motor activity rhythmic and synchronous
the presence and direction of eye deviation
was he able to respond to verbal stimulus
post ictal? for how long?
G, I'M LIMP, CAN'T STAND
Iatrogenic (paralytics, aminoglycosides, steroids)
Lou Gehrig's disease (ALS, motor neuron disease, usually gradual)
Infection (Polio, botulism)
Periodic paralysis, porphyria, paraproteinemia
Toxins (lead, arsenic, pufferfish, tick paralysis)
Systemic illness (anemia)
Neuromuscular junction disease
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