Ocular Myasthenia Case Study
The patient is a 70-year-old gentleman who was seen by Dr. Porter's office several months ago having painful ambulation and weakness of the left leg. The patient has a history of ocular myasthenia and had been seen as as an outpatient by Dr. Beth Stein. He is also reporting falls at home 2 months prior to this admission. At the time of his visit 2 months ago he had decreased strength, flexion of the hip and knee accompanied by pain and that is why he was sent for a neurologic exam on 2/7 and 2/21. However, the patient's symptoms worsened and has become completely unable to walk. He is admitted acutely inpatient. He is seen, as previously stated by neurology who reviewed all of his exams and felt that he, she is very concerned for a myopathy
or lumbar cord pathology radiculopathy she felt it was less likely to be an MG flare. When seen by orthopedics it was noted on x-rays the patient in fact has avascular necrosis of the head of the femur with left hip pain and weakness. They will attempt to get an MRI to rule out any lumbar pathology. They felt that his weakness is likely secondary the avascular necrosis but, as well as possible myasthenia gravis flare. I believe this patient warrants acute inpatient hospitalization to fully clarify the etiology of his weakness and to have him have appropriate treatment so as to not suffer further injury.
or lumbar cord pathology radiculopathy she felt it was less likely to be an MG flare. When seen by orthopedics it was noted on x-rays the patient in fact has avascular necrosis of the head of the femur with left hip pain and weakness. They will attempt to get an MRI to rule out any lumbar pathology. They felt that his weakness is likely secondary the avascular necrosis but, as well as possible myasthenia gravis flare. I believe this patient warrants acute inpatient hospitalization to fully clarify the etiology of his weakness and to have him have appropriate treatment so as to not suffer further injury.